| Doctor Name: | KATHLEEN MARY GRADY |
| NPI Number: | 1144415225 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN-BC,FNP |
| License Number: | 97380-030 |
| Business Practice Address: | 161 Washington St Suite 1400 Conshohocken, PA - 194282083 |
| Business Phone Number: | 8668253227 |
| Business Fax Number: | 4843513800 |
| Mailing Address: | 161 Washington St, Suite 1400 CONSHOHOCKEN |
| State: | PA |
| Postal Code: | 194282083 |
| Phone Number: | 8668253227 |
| Fax Number: | 4843513800 |
| NPI Enumeration Date: | 09/11/2007 |
| NPI Last Update Date: | 09/11/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 97380-030 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |