Individual
MS. KATHY ANN DALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
084053883RN
OR
163WC0400X
Case Management Registered Nurse
Primary
084053883RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
084053883RN
OREGON RN LICENSE NUMBER
OR
Enumeration date
09/08/2010
Last updated
09/08/2010
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