Basic Information
| Provider Information | |||||||||
| NPI: | 1578542692 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUNDY | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | C. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD, MSN, RNCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 419 WEST HUDSON AVE. | ||||||||
| Address2: | PO BOX 1457 | ||||||||
| City: | FOLLY BEACH | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294391457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435886289 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 109 BEE ST | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294015703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435775011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APN149 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.