Basic Information
Provider Information
NPI: 1184833352
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GATER
FirstName: KATHLEEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 536
Address2:  
City: VOORHEES
State: NJ
PostalCode: 080430536
CountryCode: US
TelephoneNumber: 8566696050
FaxNumber: 8566510794
Practice Location
Address1: 123 FRANKLIN CORNER RD
Address2: SUITE 214
City: LAWRENCEVILLE
State: NJ
PostalCode: 086482526
CountryCode: US
TelephoneNumber: 6098961400
FaxNumber: 6098963986
Other Information
ProviderEnumerationDate: 05/22/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000X26NO05190100NJY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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