Provider Demographics
NPI:1861152480
Name:MILLER, KATHERINE MARIA (NP)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:MARIA
Last Name:MILLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:330 MOUNT AUBURN ST.
Mailing Address - Street 2:SUITE 407
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138
Mailing Address - Country:US
Mailing Address - Phone:617-868-7456
Mailing Address - Fax:617-873-0837
Practice Address - Street 1:330 MOUNT AUBURN ST.
Practice Address - Street 2:SUITE 407
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138
Practice Address - Country:US
Practice Address - Phone:617-868-7456
Practice Address - Fax:617-873-0837
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-22
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAF08211183363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily