Provider Demographics
NPI:1235413881
Name:PRIOLO, KATHLEEN MARGARET (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MARGARET
Last Name:PRIOLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 GROS BLVD
Mailing Address - Street 2:
Mailing Address - City:HERKIMER
Mailing Address - State:NY
Mailing Address - Zip Code:13350-1455
Mailing Address - Country:US
Mailing Address - Phone:315-866-8562
Mailing Address - Fax:315-866-8568
Practice Address - Street 1:255 GROS BLVD
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-1455
Practice Address - Country:US
Practice Address - Phone:315-866-8562
Practice Address - Fax:315-866-8568
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268828-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool