1275552820 NPI number — MISS ANN CATHERINE EVANS MBA, ATC

Table of content: MISS ANN CATHERINE EVANS MBA, ATC (NPI 1275552820)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275552820 NPI number — MISS ANN CATHERINE EVANS MBA, ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EVANS
Provider First Name:
ANN
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MBA, ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275552820
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
556 HOGE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45226-1107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-532-1774
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1018 TOWN DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILDER
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41076
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-572-0710
Provider Business Practice Location Address Fax Number:
859-572-0716
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  1257 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2255A2300X , with the licence number: 1257 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com