Provider Demographics
NPI:1629484860
Name:NAGEL, KATHERINE (NP)
Entity Type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:
Last Name:NAGEL
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 1:1320 YORK AVE
Mailing Address - Street 2:APT. 23T
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4800
Mailing Address - Country:US
Mailing Address - Phone:203-858-2089
Mailing Address - Fax:
Practice Address - Street 1:1320 YORK AVE
Practice Address - Street 2:APT. 23T
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4800
Practice Address - Country:US
Practice Address - Phone:203-858-2089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22 658323163W00000X
NY339438363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse