1336491844 NPI number — KATHLEEN M. MASHINTONIO MSN, CRNP, NP-C

Table of content: KATHLEEN M. MASHINTONIO MSN, CRNP, NP-C (NPI 1336491844)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336491844 NPI number — KATHLEEN M. MASHINTONIO MSN, CRNP, NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MASHINTONIO
Provider First Name:
KATHLEEN
Provider Middle Name:
M.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN, CRNP, NP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOLLWEILER
Provider Other First Name:
KATHLEEN
Provider Other Middle Name:
M.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSN,CRNP,NP-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336491844
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 OSTRUM ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18015-1000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-526-6048
Provider Business Mailing Address Fax Number:
484-526-6500

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2003 SULLIVAN TRL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EASTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18040-8339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-503-6400
Provider Business Practice Location Address Fax Number:
484-503-6401
Provider Enumeration Date:
10/08/2012

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: 363L00000X , with the licence number:  SP012424 , 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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