Provider Demographics
NPI:1649517343
Name:CUTTING, KATRINA (RN)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:CUTTING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 CORNELIUS AVE
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-5943
Mailing Address - Country:US
Mailing Address - Phone:518-377-1856
Mailing Address - Fax:518-377-1099
Practice Address - Street 1:1100 CORNELIUS AVE
Practice Address - Street 2:
Practice Address - City:NISKAYUNA
Practice Address - State:NY
Practice Address - Zip Code:12309-5943
Practice Address - Country:US
Practice Address - Phone:518-377-1856
Practice Address - Fax:518-377-1099
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY464078-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY163WOOOOOXMedicaid