Provider Demographics
NPI:1194189597
Name:DALTON, KATHARINE (NP)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:DALTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-212-0497
Mailing Address - Fax:859-577-0791
Practice Address - Street 1:272 BIELBY RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1056
Practice Address - Country:US
Practice Address - Phone:859-212-0497
Practice Address - Fax:812-577-0791
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 18918 NP363LG0600X
KY3015910363L00000X
IN71010979A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology