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General NPI Number Information
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NPI Number | 1609492107
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Entity Type | Individual
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Provider Name | KATHERINE NIEMELA RN, MN
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Gender | Female
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Dates
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Enumeration Date | 06/19/2020
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Last Update Date | 06/19/2020
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Provider Practice Location Address
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Address Line | 5619 W 4TH ST SUITE 5
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City | LOS ANGELES
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State | CA
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Zip | 90036
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Country | US
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Telephone | 310-880-4737
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 PRIMROSE AVE APT 8
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City | HOLLYWOOD
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State | CA
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Zip | 90068-2899
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Country | US
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Telephone | 310-880-4737
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | RN386956
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License Number State | CA
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