Moon, Kathryn Kolb

Moon, Kathryn Kolb is an individual health care provider with primary practice located at 1900 Woodland Dr Urology, Coos Bay OR 97420-2045. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Moon, Kathryn Kolb can be contacted via phone (541) 267-5151.

Contact Information

Primary practice address
1900 Woodland Dr Urology Coos Bay OR 97420-2045
Phone: (541) 267-5151
Fax: (541) 266-4574
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 200442251RN Oregon
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 200450152NP Oregon

Profile Details

NPI number 1508897778
LBN Legal business name Moon, Kathryn Kolb
Credentials M.S.N., F.N.P-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Aug 8th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508897778 NPPES
Oregon MEDICAID 292415
Oregon Other R0000WFBTV
Oregon Other 161133
Oregon Other 93-0635514
Oregon Other 1407812365
Oregon Other P01673840

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