Provider Demographics
NPI:1356547806
Name:TAUER, KATHLEEN MARY (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARY
Last Name:TAUER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:700 E FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-2328
Mailing Address - Country:US
Mailing Address - Phone:804-225-2719
Mailing Address - Fax:804-371-0727
Practice Address - Street 1:700 E FRANKLIN ST
Practice Address - Street 2:DEPT OF JUVENILE JUSTICE
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-2328
Practice Address - Country:US
Practice Address - Phone:804-225-2719
Practice Address - Fax:804-371-0727
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024071863363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics