Provider Demographics
NPI:1801768924
Name:SCUDERO, KATHERINE (RN, MSN, FNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:SCUDERO
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574-2159
Mailing Address - Country:US
Mailing Address - Phone:707-363-7334
Mailing Address - Fax:707-963-2959
Practice Address - Street 1:465 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-2159
Practice Address - Country:US
Practice Address - Phone:707-363-7334
Practice Address - Fax:707-963-2959
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA462379163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool