Individual
KATHY A DIVINE
Active
Individual
KATHY A DIVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
079888
MO
363LF0000X
Family Nurse Practitioner
Primary
2017003053
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AR
05
—
PENDING
—
MO
05
—
PENDING
—
OK
Enumeration date
11/23/2016
Last updated
02/03/2017
Update your record
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