Healthcare Provider Details

I. General information

NPI: 1780922104
Provider Name (Legal Business Name): KATHERINE ANN SLABONIK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2013
Last Update Date: 01/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 N 3RD ST
HARRISBURG PA
17110-2001
US

IV. Provider business mailing address

2645 N 3RD ST
HARRISBURG PA
17110-2001
US

V. Phone/Fax

Practice location:
  • Phone: 717-782-2326
  • Fax: 717-782-2709
Mailing address:
  • Phone: 717-782-2326
  • Fax: 717-782-2709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN628796
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: