Provider Demographics
NPI:1306811922
Name:WILLIAMS, KATE H (GNP)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:H
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-368-3150
Mailing Address - Fax:508-368-3166
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:SUITE 230 S
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:508-368-3150
Practice Address - Fax:508-368-3166
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225943363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP1515OtherBLUE SHIELD INDEMNITY
042472266039OtherTRICARE CHAMPUS
4142221OtherMVP HEALTH CARE
NP1515OtherBLUE CARE ELECT
NP1515OtherMEDICARE B
042472266OtherPRIVATE HEALTHCARE SYSTEM
042472266OtherTHREE RIVERS
MA0363171Medicaid
NP1515OtherBLUE SHIELD HMO BLUE
0363171OtherMEDICAID WELFARE
500009482OtherRAILROAD MEDICARE
50145OtherFALLON COMMUNITY HEALTH P
AA3633OtherHARVARD PILGRIM HEALTHCAR
50145OtherFALLON COMMUNITY HEALTH P
AA3633OtherHARVARD PILGRIM HEALTHCAR