Most Relevant Information
Provider Data
| NPI Number: | 1003047663 |
| Provider Name: | KATHY AGNESE R.N. |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC0400X |
| Specialty: | Registered Nurse |
| License Number: | 724431 |
Most Important Dates
| Enumeration Date: | 07/30/2009 |
| Last Updated: | 07/30/2009 |
Provider Practice Location
14644B LAKESHORE DR
CLEARLAKE
CA
954229290
Practice Location Phone/Fax
| Phone: | 7079951606 |
| Fax: | 7079950309 |
Provider Mailing Location
14644B LAKESHORE DR
CLEARLAKE
CA
954229290
Provider Mailing Phone/Fax
| Phone: | 7079951606 |
| Fax: | 7079950309 |