Healthcare Provider Details

I. General information

NPI: 1437120391
Provider Name (Legal Business Name): KATHY M KAUFMAN CRNP,PHD,LPC,NCC,BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 12/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 CHESTNUT ST
EMMAUS PA
18049-1952
US

IV. Provider business mailing address

1605 N CEDAR CREST BLVD STE. 618
ALLENTOWN PA
18104-2351
US

V. Phone/Fax

Practice location:
  • Phone: 610-966-5549
  • Fax: 610-967-0204
Mailing address:
  • Phone: 610-435-2420
  • Fax: 610-435-2620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP015380
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC002267
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: