Provider Demographics
NPI:1871699256
Name:LEGO WILKIN, KATHRYN (RN,APN,C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:LEGO WILKIN
Suffix:
Gender:F
Credentials:RN,APN,C
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:210 ROUTE US 9 S STE 106
Mailing Address - Street 2:C/O HOPE COMMUNITY CANCER CTR
Mailing Address - City:MARMORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08223-1271
Mailing Address - Country:US
Mailing Address - Phone:609-390-7888
Mailing Address - Fax:609-390-2614
Practice Address - Street 1:210 S SHORE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1200
Practice Address - Country:US
Practice Address - Phone:609-390-7888
Practice Address - Fax:609-390-2614
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2010-03-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00046000363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health