Provider Demographics
NPI:1053745604
Name:SPATES, KATHRYN ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:SPATES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PEACE CORPS OFFICE OF MEDICAL SERVICES
Mailing Address - Street 2:1111 20TH ST. NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20526-0001
Mailing Address - Country:US
Mailing Address - Phone:202-692-1634
Mailing Address - Fax:202-692-1501
Practice Address - Street 1:PEACE CORPS OFFICE OF MEDICAL SERVICES
Practice Address - Street 2:1111 20TH ST. NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20526-0001
Practice Address - Country:US
Practice Address - Phone:202-692-1634
Practice Address - Fax:202-692-1501
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1002314363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care