Provider Demographics
NPI: | 1922230184 |
---|---|
Name: | POCIUS, KATE E (APN) |
Entity Type: | Individual |
Prefix: | MS |
First Name: | KATE |
Middle Name: | E |
Last Name: | POCIUS |
Suffix: | |
Gender: | F |
Credentials: | APN |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 191 |
Mailing Address - Street 2: | PROVIDER ENROLLMENT DEPT |
Mailing Address - City: | ROCKLAND |
Mailing Address - State: | DE |
Mailing Address - Zip Code: | 19732-0191 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 302-651-4000 |
Mailing Address - Fax: | 302-651-4945 |
Practice Address - Street 1: | 1600 ROCKLAND RD |
Practice Address - Street 2: | DIV. OF PEDIATRIC CARDIOLOGY |
Practice Address - City: | WILMINGTON |
Practice Address - State: | DE |
Practice Address - Zip Code: | 19803-3607 |
Practice Address - Country: | US |
Practice Address - Phone: | 302-651-4000 |
Practice Address - Fax: | 302-651-5345 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2009-08-20 |
Last Update Date: | 2011-09-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
DE | L10000251 | 363L00000X |
DE | L10037897 | 363L00000X |
PA | SP009962 | 363L00000X |
PA | RN533314 | 363L00000X |
DE | LJ0000251 | 2080P0202X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
No | 2080P0202X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology |