Provider Demographics
NPI:1275890311
Name:ZELTMANN, KATHLEEN ROSE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ROSE
Last Name:ZELTMANN
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 1:3 SAND ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:NY
Mailing Address - Zip Code:13673-3163
Mailing Address - Country:US
Mailing Address - Phone:315-642-3432
Mailing Address - Fax:315-642-5650
Practice Address - Street 1:3 SAND ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:NY
Practice Address - Zip Code:13673-3163
Practice Address - Country:US
Practice Address - Phone:315-642-3432
Practice Address - Fax:315-642-5650
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY476871163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse