Provider Demographics
NPI:1285691261
Name:LETKE, KATHLEEN FRANCES (MSNRNCS)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:FRANCES
Last Name:LETKE
Suffix:
Gender:F
Credentials:MSNRNCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 MARQUETTE DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3488
Mailing Address - Country:US
Mailing Address - Phone:919-302-5582
Mailing Address - Fax:919-439-5396
Practice Address - Street 1:120 MARQUETTE DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-3488
Practice Address - Country:US
Practice Address - Phone:919-302-5582
Practice Address - Fax:919-439-5396
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC157383163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1263YOtherNC BCBS
NC2599192Medicare PIN