Provider Demographics
NPI:1568724698
Name:ROTHWELL, KERRI MARIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:MARIE
Last Name:ROTHWELL
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:MARIE
Other - Last Name:MADIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:77 MAIN STREET
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-3960
Mailing Address - Country:US
Mailing Address - Phone:774-509-5059
Mailing Address - Fax:774-250-2693
Practice Address - Street 1:77 MAIN STREET
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-3960
Practice Address - Country:US
Practice Address - Phone:508-589-5333
Practice Address - Fax:774-250-2693
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2278828163WP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health