Provider Demographics
NPI:1659602746
Name:TAPPER, KATHLEEN B (CRNA)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:B
Last Name:TAPPER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5039 SWAMP RD
Mailing Address - Street 2:SUITE 406
Mailing Address - City:FOUNTAINVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18923-9667
Mailing Address - Country:US
Mailing Address - Phone:215-348-1523
Mailing Address - Fax:215-348-9501
Practice Address - Street 1:5039 SWAMP RD
Practice Address - Street 2:SUITE 406
Practice Address - City:FOUNTAINVILLE
Practice Address - State:PA
Practice Address - Zip Code:18923-9667
Practice Address - Country:US
Practice Address - Phone:215-348-1523
Practice Address - Fax:215-348-9501
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN298015L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered