Provider Demographics
NPI:1659473387
Name:PISCANI, KATHLEEN E (RN CNS APRN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:PISCANI
Suffix:
Gender:F
Credentials:RN CNS APRN
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:E
Other - Last Name:FOLKERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5055
Mailing Address - Street 2:
Mailing Address - City:BAY PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33774-5005
Mailing Address - Country:US
Mailing Address - Phone:727-398-6661
Mailing Address - Fax:727-398-9515
Practice Address - Street 1:14360 IROQUOIS AVE
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-4405
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:727-398-9515
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3029002364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3029002OtherRN