Healthcare Provider Details

I. General information

NPI: 1558348615
Provider Name (Legal Business Name): KATHRYN MARY MCALLISTER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 E CHURCH ST BETHLEHEM HEALTH BUREAU
BETHLEHEM PA
18018-6025
US

IV. Provider business mailing address

10 E CHURCH ST BETHLEHEM HEALTH BUREAU
BETHLEHEM PA
18018-6025
US

V. Phone/Fax

Practice location:
  • Phone: 610-865-7087
  • Fax: 610-865-7326
Mailing address:
  • Phone: 610-865-7087
  • Fax: 610-865-7326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberVP004285V
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: