Provider Demographics
NPI:1083426100
Name:MACINANTI, KATHERINE (NBC-HWC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MACINANTI
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:MACINANTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NBC-HWC
Mailing Address - Street 1:56 AZALEA CIR
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02881-1796
Mailing Address - Country:US
Mailing Address - Phone:401-263-3704
Mailing Address - Fax:
Practice Address - Street 1:56 AZALEA CIR
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02881-1796
Practice Address - Country:US
Practice Address - Phone:401-263-3704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-3374279171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach