Provider Demographics
NPI:1093597429
Name:ROSS, KATHLEEN ANN (RNBC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:ROSS
Suffix:
Gender:F
Credentials:RNBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 178
Mailing Address - Street 2:
Mailing Address - City:WEST PITTSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16160-0178
Mailing Address - Country:US
Mailing Address - Phone:724-651-1002
Mailing Address - Fax:
Practice Address - Street 1:253 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3618
Practice Address - Country:US
Practice Address - Phone:724-531-6613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN235664L163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health