Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 01034971A | IN |
NPI | 1164427373 |
---|---|
Provider Name | Dr. Kathryn L. Press |
First Address | Elkhart, IN 46515-2968 |
Second Address | Elkhart, IN 46514-2066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2005 |
Last Update Date | 19/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000090113 | ANTHEM (01) | IN |
040003369 | RR MEDICARE (01) | IN |
100113280A | (05) | IN |
B28648 | (02) | IN |