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NPI Code Detail

MEDICARE: KATHARINE ELIZABETH MILLER WALSH CET I

MEDICARE: KATHARINE ELIZABETH MILLER WALSH CET I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1467103838
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHARINE ELIZABETH MILLER WALSH CET I
Provider Business Mailing Address
First Line : 1045 S 50TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19143-3305
Country : US
Telephone Number : 610-731-8785
Fax Number :
Provider Business Practice Location Address
First Line : 524 N PROVIDENCE RD
Second Line :
City : MEDIA
State : PA
Zip : 19063-3056
Country : US
Telephone Number : 484-440-9416
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2022
Last Update Date : 01/17/2022

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