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General NPI Number Information
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NPI Number | 1235589938
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Entity Type | Individual
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Provider Name | KATHLEEN F ELSENER M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 3259 CATLIN AVE
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City | QUANTICO
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State | VA
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Zip | 22134-5109
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Country | US
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Telephone | 703-784-1713
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Fax | 703-784-1987
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Provider Business Mailing Address
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Address Line | 3259 CATLIN AVE
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City | QUANTICO
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State | VA
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Zip | 22134-5109
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Country | US
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Telephone | 703-784-1713
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Fax | 703-784-1987
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101276364
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License Number State | VA
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