Individual
KATHLEEN DANIELLE ENNIS
Active
Individual
KATHLEEN DANIELLE ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
773322
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
383572
NY
Other
Enumeration date
05/06/2021
Last updated
06/15/2023
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