Individual
KATHLEEN GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1181 PADDOCK RD, SMYRNA, DE 19977-9679
(302) 653-9261
Mailing address
1181 PADDOCK RD, SMYRNA, DE 19977-9679
(302) 653-9261
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
LG-0000934
DE
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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