Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 041414 | CT |
N | 207PP0204X | Pediatric Emergency Physician | 041414 | CT |
N | 208000000X | Pediatrician | 041414 | CT |
N | 2080P0204X | Pediatric Emergency Doctor | 041414 | CT |
NPI | 1548235088 |
---|---|
Provider Name | Katherine Frances Mcgowan Hesse |
First Address | New London, CT 06320-4700 |
Second Address | New London, CT 06320-4700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2006 |
Last Update Date | 19/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001414143 | (05) | CT |
G55273 | (02) | CT |