Provider Demographics
NPI:1184467037
Name:AMPUERO LLANOS, KATHERINE VALERIA SR
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:VALERIA
Last Name:AMPUERO LLANOS
Suffix:SR
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:CATASAUQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18032-2746
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1146 4TH STREET
Practice Address - Street 2:
Practice Address - City:CATASAUQUA
Practice Address - State:PA
Practice Address - Zip Code:18032-2746
Practice Address - Country:US
Practice Address - Phone:484-943-7461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator