| Doctor Name: | KATHARINE C SPORER |
| NPI Number: | 1396725792 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | 26NO07781900 |
| Business Practice Address: | 107 E Mantua Ave Wenonah, NJ - 080901950 |
| Business Phone Number: | 8564686868 |
| Business Fax Number: | 8564641855 |
| Mailing Address: | 107 E Mantua Ave, WENONAH |
| State: | NJ |
| Postal Code: | 080901950 |
| Phone Number: | 8564686868 |
| Fax Number: | 8564641855 |
| NPI Enumeration Date: | 01/20/2006 |
| NPI Last Update Date: | 12/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 26NO07781900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |