Individual provider · Type 1 NPI

Kathleen Judith Carroll-Hack, PNP

Pediatric Nurse Practitioner · Sacramento, CA

NPI number 1679660294 Active

Practice location

7275 E Southgate Dr, Suite 306
Sacramento, CA 95823-2628

Call (916) 422-6635 Map

Fax (916) 422-2741

Mailing address

130 Orrington Cir
Sacramento, CA 95835-1623

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X13696 (CA)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1679660294

Kathleen Judith Carroll-Hack, PNP's National Provider Identifier is 1679660294, issued on Oct 6, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Sacramento, CA. The record was last updated on Jul 8, 2007.