Provider Demographics
NPI:1336376789
Name:SORIANO, KATHERN MARIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:KATHERN
Middle Name:MARIE
Last Name:SORIANO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 54H
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:WV
Mailing Address - Zip Code:24924-9659
Mailing Address - Country:US
Mailing Address - Phone:304-799-6695
Mailing Address - Fax:304-799-6644
Practice Address - Street 1:RR 2 BOX 54G
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:WV
Practice Address - Zip Code:24924-9641
Practice Address - Country:US
Practice Address - Phone:304-799-6695
Practice Address - Fax:304-799-6644
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV41655363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily