Provider Demographics
NPI:1689681157
Name:PESCE, KATHRYN G (APN)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:G
Last Name:PESCE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:G
Other - Last Name:HOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1805 INGLESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-2105
Mailing Address - Country:US
Mailing Address - Phone:423-745-8802
Mailing Address - Fax:
Practice Address - Street 1:1805 INGLESIDE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-2105
Practice Address - Country:US
Practice Address - Phone:423-745-8802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000011702363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3642173Medicare ID - Type Unspecified