Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 33727 | SC |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 57.028163 | OH |
NPI | 1740577477 |
---|---|
Provider Name | Kristen Miller Nathe |
First Address | Belfast, ME 04915-4473 |
Second Address | Columbia, SC 29203-6882 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2011 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
337273 | (05) | SC |