Provider Demographics
NPI:1972886778
Name:KWIATKOWSKI, KATHLEEN MICHELE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MICHELE
Last Name:KWIATKOWSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:2218 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-9701
Mailing Address - Country:US
Mailing Address - Phone:716-375-8945
Mailing Address - Fax:716-375-8950
Practice Address - Street 1:411 W HENLEY ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-3541
Practice Address - Country:US
Practice Address - Phone:716-375-8945
Practice Address - Fax:716-375-8950
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY568152-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool