Provider Demographics
NPI:1881935351
Name:KLEIN, KATHERINE COLLERAN (RN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:COLLERAN
Last Name:KLEIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 CREEKRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-9458
Mailing Address - Country:US
Mailing Address - Phone:803-643-0560
Mailing Address - Fax:
Practice Address - Street 1:170 FLINT DR
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29851-2352
Practice Address - Country:US
Practice Address - Phone:803-593-7180
Practice Address - Fax:803-593-7112
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25968163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool