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General NPI Number Information
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NPI Number | 1013483064
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Entity Type | Individual
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Provider Name | KATHERINE MCKINNON RN, NP
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Gender | Female
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Dates
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Enumeration Date | 10/17/2018
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 1126 S GOLD ST
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City | CENTRALIA
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State | WA
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Zip | 98531-3768
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Country | US
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Telephone | 206-234-9139
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Fax | 844-612-6673
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Provider Business Mailing Address
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Address Line | 1126 S GOLD ST
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City | CENTRALIA
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State | WA
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Zip | 98531-3768
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Country | US
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Telephone | 360-807-4929
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Fax | 844-612-6673
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN60082163
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61584538
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License Number State | WA
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