Individual
KATHLEEN JOAN WOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP EDD
Contact information
Practice address
33-57 HARRISON ST, HOSPITALIST PROGRAM - TCU, JOHNSON CITY, NY 13790-2107
(607) 763-6622
(607) 763-5064
Mailing address
346 GRAND AVE, UNITED MEDICAL ASSOCAITES PC, JOHNSON CITY, NY 13790-2558
(607) 770-0025
(607) 729-3982
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F301130
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F301130
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02463156
—
NY
Enumeration date
01/03/2006
Last updated
01/29/2009
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