Provider Demographics
NPI:1548676091
Name:TRAN, KATHERINE (FNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 MAPLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1825 MAPLE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-2723
Practice Address - Country:US
Practice Address - Phone:716-886-5493
Practice Address - Fax:716-886-5835
Is Sole Proprietor?:No
Enumeration Date:2014-07-05
Last Update Date:2014-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338790363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily