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General NPI Number Information
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NPI Number | 1366303406
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Entity Type | Individual
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Provider Name | KATELYN BOTTCHER
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Gender | Female
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 800 SPRUCE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-6130
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Country | US
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Telephone | 732-956-4488
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Fax |
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Provider Business Mailing Address
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Address Line | 195 CAROLYN AVE
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City | COLONIA
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State | NJ
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Zip | 07067-1733
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP034706
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License Number State | PA
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