Provider Demographics
NPI:1083263594
Name:LEMONS, KATHERINE (PA-C, MS, CNS)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:LEMONS
Suffix:
Gender:
Credentials:PA-C, MS, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MIDDLESEX AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-1102
Mailing Address - Country:US
Mailing Address - Phone:617-591-6900
Mailing Address - Fax:
Practice Address - Street 1:5 MIDDLESEX AVE FL 1
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-1102
Practice Address - Country:US
Practice Address - Phone:617-591-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-06
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19052133N00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133N00000XDietary & Nutritional Service ProvidersNutritionist