Kathryn Ann Fallon, NURSE PRACTITIONER
Individual provider Active NPI Family Nurse Practitioner · Old Lyme, CT
NPI 1316129455 · NPPES record last updated Nov 30, 2007
Key facts
- NPI
- 1316129455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 002085 (CT)
- Practice address
- 8 Ascot LN
Old Lyme, CT 06371-1870 - Phone
- (860) 434-1008
- NPI assigned
- Nov 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002085 | CT | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 002085 | CT | Yes |
Addresses
Primary practice location
8 Ascot LN
Old Lyme, CT 06371-1870
Mailing address
8 Ascot LN
Old Lyme, CT 06371-1870
Phone (860) 434-1008
Other providers in Old Lyme, CT
- Robert Dean
- Michelle Kathryn Deyorio
- Terrence A Doherty
- Karen G Donovan
- Douglas Scott Eads
- Deborah Feigenbaum
- Cristan Filippi
- Brett J.M. Flynn
- Karl R. Friedmann
- Frontline Wellness LLC
All providers in Old Lyme, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.