Provider Demographics
NPI:1184046922
Name:YORK, KATHLEEN ELAINE (FNP)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ELAINE
Last Name:YORK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:KATHLEEN
Other - Middle Name:ELAINE
Other - Last Name:SIZEMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:307 MANUFACTURERS RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-3200
Mailing Address - Country:US
Mailing Address - Phone:423-755-8880
Mailing Address - Fax:
Practice Address - Street 1:307 MANUFACTURERS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-3200
Practice Address - Country:US
Practice Address - Phone:423-755-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18167363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily