Provider Demographics
NPI:1003151796
Name:GIROUX-PFISTER, KATHLEEN MARY (APN)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARY
Last Name:GIROUX-PFISTER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6945 CARLISLE CT BLDG D
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-6883
Mailing Address - Country:US
Mailing Address - Phone:239-260-5891
Mailing Address - Fax:239-260-5895
Practice Address - Street 1:6945 CARLISLE CT BLDG D
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-6883
Practice Address - Country:US
Practice Address - Phone:239-260-5891
Practice Address - Fax:239-260-5895
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001095363LF0000X
IL27701294363LF0000X
IL209.010052363LF0000X
FL9404489363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL20150720295836Medicaid