Healthcare Provider Details

I. General information

NPI: 1497820237
Provider Name (Legal Business Name): KATHLEEN S. KAESS M.S.N., A.P.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1059 S BRADFORD ST
DOVER DE
19904-4141
US

IV. Provider business mailing address

1059 S BRADFORD ST
DOVER DE
19904-4141
US

V. Phone/Fax

Practice location:
  • Phone: 302-736-6135
  • Fax: 302-736-0172
Mailing address:
  • Phone: 302-736-6135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberLE-0000109
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: