Individual provider Active NPI

Kathleen Holler, RN EMS

  • Registered Nurse
  • North Tonawanda, NY
National Provider Identifier
1003687088
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
404494 Issued in NY
Practice address
1392 Sweeney St
North Tonawanda, NY 14120-4876
Phone
(716) 417-3916
NPI assigned
Jan 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 404494 NY
Registered Nurse 163W00000X 404494 NY Primary

Addresses

Primary practice location

1392 Sweeney St
North Tonawanda, NY 14120-4876

Mailing address

1392 Sweeney St
North Tonawanda, NY 14120-4876
Phone (716) 417-3916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
404494NYMDGeneral Practice Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1003687088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1392 SWEENEY ST",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141204876",
            "telephone_number": "716-417-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1392 SWEENEY ST",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141204876",
            "telephone_number": "716-417-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLER",
        "first_name": "KATHLEEN",
        "credential": "RN EMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "404494",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "404494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.