Deandrade, Kolleen M

Deandrade, Kolleen M is an individual health care provider with primary practice located at 363 Highland Ave , Fall River MA 02720-3703. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Deandrade, Kolleen M can be contacted via phone (508) 973-7018.

Contact Information

Primary practice address
363 Highland Ave Fall River MA 02720-3703
Phone: (508) 973-7018
Fax: (508) 973-7147
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA278 Massachusetts

Profile Details

NPI number 1851596704
LBN Legal business name Deandrade, Kolleen M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2007
Last updated Jun 4th, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851596704 NPPES
New Hampshire MEDICAID 3139163

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