Provider Demographics
NPI:1225271968
Name:GOODPASTURE, KATHERINE ANN I (DO)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ANN
Last Name:GOODPASTURE
Suffix:I
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:ANN
Other - Last Name:SCHEER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1620 CHARLES PL
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2750
Mailing Address - Country:US
Mailing Address - Phone:785-776-1400
Mailing Address - Fax:785-776-7392
Practice Address - Street 1:1620 CHARLES PL
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2750
Practice Address - Country:US
Practice Address - Phone:785-776-1400
Practice Address - Fax:785-776-7392
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KS05-36671207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program