Provider Demographics
NPI:1659499564
Name:TOBER, KATHRYN RUTH (RN)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:RUTH
Last Name:TOBER
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 1:22497 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-2564
Mailing Address - Country:US
Mailing Address - Phone:302-381-4429
Mailing Address - Fax:
Practice Address - Street 1:20346 ENNIS RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-4108
Practice Address - Country:US
Practice Address - Phone:302-856-1930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL10034301163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool