Provider Demographics
NPI:1487904553
Name:LAW, KATHERINE SUSANNE (RN)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:SUSANNE
Last Name:LAW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1623 HOSPITAL LOOP
Mailing Address - Street 2:HWY 225
Mailing Address - City:OWYHEE
Mailing Address - State:NV
Mailing Address - Zip Code:89832-0130
Mailing Address - Country:US
Mailing Address - Phone:775-757-2415
Mailing Address - Fax:775-757-2066
Practice Address - Street 1:1623 HOSPITAL LOOP
Practice Address - Street 2:HWY 225
Practice Address - City:OWYHEE
Practice Address - State:NV
Practice Address - Zip Code:89832-0130
Practice Address - Country:US
Practice Address - Phone:775-757-2415
Practice Address - Fax:775-757-2066
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDN-27365163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse