Provider Demographics
NPI:1629105432
Name:ELSHOFF, KATHRYN LYNN (NP)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:LYNN
Last Name:ELSHOFF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9805 67TH AVE
Mailing Address - Street 2:9L
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4969
Mailing Address - Country:US
Mailing Address - Phone:718-897-9435
Mailing Address - Fax:
Practice Address - Street 1:3080 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-1268
Practice Address - Country:US
Practice Address - Phone:718-647-0240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily