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Individual
DR. KATHLEEN A NORDSTROM
Active
Individual
DR. KATHLEEN A NORDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
8881
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11727
—
ND
01
—
21230
DR NORDSTROM BCBS
ND
01
—
7704010
DR NORDSTROM SD MEDICAID
SD
01
—
8881
STATE LIC#
ND
01
—
920006668
DR NORDSTROM RR MEDICARE
ND
Enumeration date
02/09/2007
Last updated
12/30/2013
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