Provider Demographics
NPI:1225148208
Name:ALBERTSON, KATHRYN MARCILLE
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARCILLE
Last Name:ALBERTSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:MARCILLE
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:135 KING ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3022
Mailing Address - Country:US
Mailing Address - Phone:740-415-2058
Mailing Address - Fax:
Practice Address - Street 1:135 KING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3022
Practice Address - Country:US
Practice Address - Phone:740-415-2058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374UOOOOOX374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide