Provider Demographics
NPI:1558348615
Name:MCALLISTER, KATHRYN MARY (CRNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARY
Last Name:MCALLISTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E CHURCH ST
Mailing Address - Street 2:BETHLEHEM HEALTH BUREAU
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-6025
Mailing Address - Country:US
Mailing Address - Phone:610-865-7087
Mailing Address - Fax:610-865-7326
Practice Address - Street 1:10 E CHURCH ST
Practice Address - Street 2:BETHLEHEM HEALTH BUREAU
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6025
Practice Address - Country:US
Practice Address - Phone:610-865-7087
Practice Address - Fax:610-865-7326
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP004285V363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102685639-0001Medicaid
PA100730341-0008Medicaid