Basic Information
| Provider Information | |||||||||
| NPI: | 1336758747 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARVIN | ||||||||
| FirstName: | KATE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1025 W HARRISBURG PIKE | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170574848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7179440491 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1025 W HARRISBURG PIKE | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170574848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7179440491 | ||||||||
| FaxNumber: | 7179441436 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2020 | ||||||||
| LastUpdateDate: | 08/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | SP022305 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | SP022305 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.