Provider Demographics
NPI:1225645815
Name:HART, KATHI ANN (INDEPENDENT PROVIDER)
Entity Type:Individual
Prefix:MRS
First Name:KATHI
Middle Name:ANN
Last Name:HART
Suffix:
Gender:F
Credentials:INDEPENDENT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6710 EVERGREEN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3968
Mailing Address - Country:US
Mailing Address - Phone:937-470-6362
Mailing Address - Fax:
Practice Address - Street 1:6710 EVERGREEN WOODS DR
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-3968
Practice Address - Country:US
Practice Address - Phone:937-470-6362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker