Provider Demographics
NPI:1780679977
Name:PEARSON, KATHLEEN STEINER (CRNP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:STEINER
Last Name:PEARSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 EDMUND RD
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-2012
Mailing Address - Country:US
Mailing Address - Phone:215-886-6094
Mailing Address - Fax:
Practice Address - Street 1:1844 STREET RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-4582
Practice Address - Country:US
Practice Address - Phone:215-953-6804
Practice Address - Fax:215-953-6635
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP006543B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS72127Medicare UPIN