Provider Demographics
NPI:1336491844
Name:MASHINTONIO, KATHLEEN M (MSN, CRNP, NP-C)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:MASHINTONIO
Suffix:
Gender:F
Credentials:MSN, CRNP, NP-C
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:M
Other - Last Name:FOLLWEILER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN,CRNP,NP-C
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-6048
Mailing Address - Fax:484-526-6500
Practice Address - Street 1:2003 SULLIVAN TRL
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-8339
Practice Address - Country:US
Practice Address - Phone:484-503-6400
Practice Address - Fax:484-503-6401
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012424363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner