Provider Demographics
NPI:1558593517
Name:HARRIS, KATHLEEN MARIE (MSN CPNP)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MSN CPNP
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:MARIE
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN CPNP
Mailing Address - Street 1:250 CETRONIA RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9147
Mailing Address - Country:US
Mailing Address - Phone:610-841-3890
Mailing Address - Fax:610-841-3880
Practice Address - Street 1:250 CETRONIA RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9147
Practice Address - Country:US
Practice Address - Phone:610-841-3890
Practice Address - Fax:610-841-3880
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010372363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics