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General NPI Number Information
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NPI Number | 1033921200
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Entity Type | Individual
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Provider Name | KATHLEEN VIRGINIA MACKERROW MS, RN, CNS, GCNS-BC
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Gender | Female
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 375 LAGUNA HONDA BLVD OFC A412
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-1411
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Country | US
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Telephone | 415-759-3066
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Fax |
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Provider Business Mailing Address
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Address Line | 139 HUGO ST APT 9
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-2761
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Country | US
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Telephone | 415-215-5259
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Fax |
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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 | 163WN0800X
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Taxonomy Name | Neuroscience Registered Nurse
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License Number | 457518
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 364SG0600X
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Taxonomy Name | Gerontology Clinical Nurse Specialist
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License Number | 1253
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License Number State | CA
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