Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 12221 | CA |
NPI | 1053388645 |
---|---|
Provider Name | Ms. Katherine R Elsley |
First Address | San Francisco, CA 94110-2648 |
Second Address | San Mateo, CA 94403-4364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 08/07/2007 |