1508742982 NPI number — KATHRYN ELIZABETH MOSHOLDER FNP-BC

Table of content: ADONIS ANTONIO PALMAZ PEREZ (NPI 1285213074)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508742982 NPI number — KATHRYN ELIZABETH MOSHOLDER FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOSHOLDER
Provider First Name:
KATHRYN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SUBA
Provider Other First Name:
KATHRYN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1508742982
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/29/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 CORPORATE DR STE 107
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEDFORD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15522-7941
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-842-3206
Provider Business Mailing Address Fax Number:
814-842-9169

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
203 COLLEGE PARK PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15904-2833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-263-5804
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  SP033582 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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