| Doctor Name: | MS. KATHLEEN MARIE HERBERGER |
| NPI Number: | 1043376338 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | R090017 |
| Business Practice Address: | 8197 Westside Blvd Fulton, MD - 207592590 |
| Business Phone Number: | 3013625090 |
| Business Fax Number: | |
| Mailing Address: | 8505 Paxton Ct, BERWYN HEIGHTS |
| State: | MD |
| Postal Code: | 207402645 |
| Phone Number: | 2566834964 |
| Fax Number: | |
| NPI Enumeration Date: | 12/29/2006 |
| NPI Last Update Date: | 03/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R090017 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |