Doctor Name: | KATHRYN LEGO WILKIN |
NPI Number: | 1871699256 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN,APN,C |
License Number: | 26NJ00046000 |
Business Practice Address: | 210 S Shore Rd Suite 106 Marmora, NJ - 082231200 |
Business Phone Number: | 6093907888 |
Business Fax Number: | 6093902614 |
Mailing Address: | 210 Route Us 9 S Ste 106, C/o Hope Community Cancer Ctr MARMORA |
State: | NJ |
Postal Code: | 082231271 |
Phone Number: | 6093907888 |
Fax Number: | 6093902614 |
NPI Enumeration Date: | 09/15/2006 |
NPI Last Update Date: | 03/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 26NJ00046000 |
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: |