Individual
MS. KATHLEEN MAZZOLA
Active
Individual
MS. KATHLEEN MAZZOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP008607
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1824822
SECURITY BLUE
PA
01
—
RN202342L
REGISTERED NURSE
PA
01
—
SP008607
NURSE PRACTITIONER
PA
Enumeration date
10/06/2005
Last updated
07/29/2014
Update your record
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