Individual
KATHLEEN M FERNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
200 SOUTH MILL STREET, RIDGWAY, PA 15853
(814) 772-0722
(814) 772-6934
Mailing address
200 SOUTH MILL STREET, RIDGWAY, PA 15853
(814) 772-0722
(814) 772-6934
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS013170
PA
208D00000X
General Practice Physician
OS013170
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016386070001
—
PA
05
—
1016386070002
—
PA
01
—
1833904
HIGHMARK
PA
Enumeration date
08/09/2005
Last updated
09/25/2013
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