Basic Information
| Provider Information | |||||||||
| NPI: | 1760617195 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORDERO | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | BUZON 4 215 A | ||||||||
| Address2: | BO LLANADAS | ||||||||
| City: | ISABELA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9392471557 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | AVE AGUSTIN RAMOS CALERO | ||||||||
| Address2: | BOX 737 | ||||||||
| City: | ISABELA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878302747 | ||||||||
| FaxNumber: | 7878300465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2009 | ||||||||
| LastUpdateDate: | 05/29/2009 | ||||||||
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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 | 163W00000X | 12676 | PR | Y | Nursing Service Providers | Registered Nurse |
No ID Information.