1518195635 NPI number — MRS. KATHRYN S WALSH CRNA

Table of content: MRS. KATHRYN S WALSH CRNA (NPI 1518195635)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518195635 NPI number — MRS. KATHRYN S WALSH CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALSH
Provider First Name:
KATHRYN
Provider Middle Name:
S
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518195635
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
COTTAGE HOSPITAL
Provider Second Line Business Mailing Address:
90 SWIFTWATER ROAD
Provider Business Mailing Address City Name:
WOODSVILLE
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-747-9000
Provider Business Mailing Address Fax Number:
603-747-3310

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
COTTAGE HOSPITAL
Provider Second Line Business Practice Location Address:
90 SWIFTWATER ROAD
Provider Business Practice Location Address City Name:
WOODSVILLE
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03785
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-747-9000
Provider Business Practice Location Address Fax Number:
603-747-3310
Provider Enumeration Date:
06/26/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  101-0114867 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: RN530087L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1024431 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3100133 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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