Individual
KATHLEEN KANOTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
60 HIGHLAND ROAD, BETHEL PARK, PA 15102
(412) 831-6050
(412) 831-7465
Mailing address
110 WILLOW LANE, HOUSTON, PA 15342
(724) 745-8234
(412) 831-9270
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP008287
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KA1735077
BLUE SHIELD
PA
Enumeration date
09/20/2005
Last updated
07/08/2007
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