Individual
MS. KATHLEEN JUDITH CARROLL-HACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
7275 E SOUTHGATE DR, SUITE 306, SACRAMENTO, CA 95823-2628
(916) 422-6635
(916) 422-2741
Mailing address
130 ORRINGTON CIR, SACRAMENTO, CA 95835-1623
(916) 419-5319
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
13696
CA
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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