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General NPI Number Information
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NPI Number | 1700678869
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Entity Type | Individual
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Provider Name | KATHERINE NIELSEN L.AC.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 345 E MOUNT AIRY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19119-1114
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Country | US
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Telephone | 803-240-4509
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Fax |
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Provider Business Mailing Address
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Address Line | 115 CARPENTER LN APT 7
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City | PHILADELPHIA
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State | PA
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Zip | 19119-2573
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Country | US
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Telephone | 803-240-4509
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AK001485
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License Number State | PA
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