Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | SP021387 | PA |
NPI | 1255961389 |
---|---|
Provider Name | Mrs. Kathryn Taylor Van Hoose |
First Address | Philadelphia, PA 19104-3442 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2020 |
Last Update Date | 16/01/2020 |