Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP61205787 | WA |
NPI | 1023778529 |
---|---|
Provider Name | Katherine Jane Lepere |
First Address | Mount Vernon, WA 98274-8752 |
Second Address | Mount Vernon, WA 98274-8752 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2021 |
Last Update Date | 23/12/2021 |