Provider Demographics
NPI:1639515497
Name:MCDONALD, KATHERINE L (RN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 GREAT BROOK APTS
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-1332
Mailing Address - Country:US
Mailing Address - Phone:585-750-6868
Mailing Address - Fax:
Practice Address - Street 1:909 GREAT BROOK APTS
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-1332
Practice Address - Country:US
Practice Address - Phone:585-750-6868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY616591163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse