Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | ARNP3128332 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | SPO10317 | PA |
NPI | 1003033432 |
---|---|
Provider Name | Kathleen Ellen Kearney |
First Address | Philadelphia, PA 19104-3309 |
Second Address | Philadelphia, PA 19104-3309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 29/07/2010 |