Individual
KATHARINE C SPORER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
107 E MANTUA AVE, WENONAH, NJ 08090-1950
(856) 468-6868
(856) 464-1855
Mailing address
107 E MANTUA AVE, WENONAH, NJ 08090-1950
(856) 468-6868
(856) 464-1855
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NO07781900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2793407
—
NJ
Enumeration date
01/20/2006
Last updated
12/21/2009
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