Provider Demographics
NPI:1598844458
Name:BORROMEO, KATHRYN A (RNFA)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:A
Last Name:BORROMEO
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36475 5 MILE RD
Mailing Address - Street 2:MEDICAL STAFF OFFICE
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-1971
Mailing Address - Country:US
Mailing Address - Phone:734-655-1420
Mailing Address - Fax:734-655-1445
Practice Address - Street 1:36475 5 MILE RD
Practice Address - Street 2:MEDICAL STAFF OFFICE
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1971
Practice Address - Country:US
Practice Address - Phone:734-655-1420
Practice Address - Fax:734-655-1445
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704140063163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant