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General NPI Number Information
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NPI Number | 1689151037
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Entity Type | Individual
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Provider Name | KATHERINE TAN
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Gender | Female
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Dates
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Enumeration Date | 07/27/2018
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 4824 MCKEAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19144-4708
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Country | US
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Telephone | 757-319-2713
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Fax |
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Provider Business Mailing Address
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Address Line | 4824 MCKEAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19144-4708
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Country | US
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Telephone | 757-319-2713
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001266487
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN709596
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | MW010505
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP019491
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License Number State | PA
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