Provider Demographics
NPI:1881705515
Name:ESPEY, KATHLEEN A (RN,ANP-C)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:A
Last Name:ESPEY
Suffix:
Gender:F
Credentials:RN,ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:286 STAGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:NY
Mailing Address - Zip Code:12019-2619
Mailing Address - Country:US
Mailing Address - Phone:518-399-2101
Mailing Address - Fax:518-399-2130
Practice Address - Street 1:286 STAGE RD
Practice Address - Street 2:
Practice Address - City:CHARLTON
Practice Address - State:NY
Practice Address - Zip Code:12019-2619
Practice Address - Country:US
Practice Address - Phone:518-399-2101
Practice Address - Fax:518-399-2130
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300639363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02184747Medicaid
NY000406087001OtherBSNENY
NY200438OtherSENIOR WHOLE HEALTH
NY54258OtherGHI/HMO
NY986444OtherMVP HEALTHCARE
NY070628000071OtherFIDELIS
NY54258OtherGHI/HMO
NY070628000071OtherFIDELIS