1558593517 NPI number — MS. KATHLEEN MARIE HARRIS MSN CPNP

Table of content: MS. KATHLEEN MARIE HARRIS MSN CPNP (NPI 1558593517)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558593517 NPI number — MS. KATHLEEN MARIE HARRIS MSN CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARRIS
Provider First Name:
KATHLEEN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSN CPNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ARMSTRONG
Provider Other First Name:
KATHLEEN
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSN CPNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558593517
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
250 CETRONIA RD
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18104-9147
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-841-3890
Provider Business Mailing Address Fax Number:
610-841-3880

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 CETRONIA RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-9147
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-841-3890
Provider Business Practice Location Address Fax Number:
610-841-3880
Provider Enumeration Date:
08/10/2009

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: 363LP0200X , with the licence number:  SP010372 , 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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