| Doctor Name: | KATHRYN KANNELY |
| NPI Number: | 1235528670 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN00113929 |
| Business Practice Address: | 901 Ahlers Rd Royal City, WA - 993570486 |
| Business Phone Number: | 5093462268 |
| Business Fax Number: | 5093462269 |
| Mailing Address: | 921 Ahlers Rd, Po Box 486 ROYAL CITY |
| State: | WA |
| Postal Code: | 99357 |
| Phone Number: | 5093462268 |
| Fax Number: | 5093462269 |
| NPI Enumeration Date: | 01/22/2015 |
| NPI Last Update Date: | 01/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | RN00113929 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |