Basic Information
| Provider Information | |||||||||
| NPI: | 1215064324 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCEACHERN | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 999 S RIVER ST | ||||||||
| Address2: | |||||||||
| City: | MARSHFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020502563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818341540 | ||||||||
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| Practice Location | |||||||||
| Address1: | 55 FRUIT ST BIGELOW 800 | ||||||||
| Address2: | MGH HEART FAILURE ANDTRANSPLANT SERVICE | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177241400 | ||||||||
| FaxNumber: | 6177264105 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2007 | ||||||||
| LastUpdateDate: | 01/21/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 136665 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.