Individual provider · Type 1 NPI
Kathleen Doherty, CRNP
Primary Care Nurse Practitioner · Clarks Summit, PA
NPI number
1629776125
Active
Practice location
255 E Grove Street
Clarks Summit, PA 18411
Mailing address
255 E Grove St
Clarks Summit, PA 18411
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | SP025239 (PA) |
Primary Care Nurse Practitioner: Definition to come...
About NPI 1629776125
Kathleen Doherty, CRNP's National Provider Identifier is 1629776125, issued on Feb 23, 2023. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Clarks Summit, PA. The record was last updated on Aug 13, 2024.