KATHRYN A PROULX CNP PH.D. NPI 1376621615

NPI Information

NPI: 1376621615
Provider Name: KATHRYN A PROULX, CNP, PH.D.
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1049 MAIN ST
SPRINGFIELD, MA
ZIP 01103
Phone: (413) 739-1100
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Kathryn A Proulx, CNP, PH.D. is a psychiatric/mental health nurse practitioner in Springfield, MA with 32 years of experience. Kathryn A Proulx, CNP, PH.D. NPI is 1376621615. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1049 MAIN ST
SPRINGFIELD, MA
ZIP 01103-114
Phone: (413) 739-1100
Fax: (413) 304-4666

The NPI 1376621615 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/2/2006 and was last updated on 12/16/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WP0808X	Registered Nurse	Psychiatric/Mental Health	127180	MASSACHUSETTS	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	001162	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	110028120	MEDICAID	MASSACHUSETTS
2	M21172	MEDICARE UPIN	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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