Basic Information
| Provider Information | |||||||||
| NPI: | 1821483546 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAMES | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | TINDALL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1225 WHITEHORSE MERCERVILLE RD | ||||||||
| Address2: | BLDG. D, SUITE 220 | ||||||||
| City: | MERCERVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086193882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095812200 | ||||||||
| FaxNumber: | 6095811212 | ||||||||
| Practice Location | |||||||||
| Address1: | 1225 WHITEHORSE MERCERVILLE RD | ||||||||
| Address2: | BLDG. D, SUITE 220 | ||||||||
| City: | MERCERVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086193882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095812200 | ||||||||
| FaxNumber: | 6095811212 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2015 | ||||||||
| LastUpdateDate: | 03/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 25MP00362200 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.