Provider Demographics
NPI:1255678736
Name:CARTER, CATHLEEN
Entity Type:Individual
Prefix:MS
First Name:CATHLEEN
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CATHLEEN
Other - Middle Name:
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:633 STORMS RD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3357
Mailing Address - Country:US
Mailing Address - Phone:937-270-7989
Mailing Address - Fax:
Practice Address - Street 1:633 STORMS RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-3357
Practice Address - Country:US
Practice Address - Phone:937-270-7989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 317225163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health