Individual provider · NPI-1

Katherine Kaelin, NP-C

Nurse Practitioner, Family · Islandia, NY

NPI number1376143495
StatusActive
Last updated in NPPESAug 29, 2023

Details

NPI
1376143495
Entity type
Individual (NPI-1)
Name
Katherine Kaelin
Credential
NP-C
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 28, 2020
Certification date
Aug 29, 2023
Last updated
Aug 29, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family346871NYYes

Practice location

3001 Express Dr N
Islandia, NY 11749-5301

Phone 631-292-6747

Mailing address

3001 Express Dr N
Islandia, NY 11749-5301

Phone 631-292-6747

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