Provider Demographics
NPI:1407147879
Name:HANLON, KATHERINE ANNE (MSN, CRNP, CPNP)
Entity Type:Individual
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First Name:KATHERINE
Middle Name:ANNE
Last Name:HANLON
Suffix:
Gender:F
Credentials:MSN, CRNP, CPNP
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Other - Middle Name:
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Mailing Address - Street 1:3400 CIVIC CENTER BLVD
Mailing Address - Street 2:1 WOOD CENTER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5127
Mailing Address - Country:US
Mailing Address - Phone:215-590-3440
Mailing Address - Fax:215-590-3986
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:1 WOOD CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5127
Practice Address - Country:US
Practice Address - Phone:215-590-3440
Practice Address - Fax:215-590-3986
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2014-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP011252363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics