Provider Demographics
NPI:1417160979
Name:THARP, KATHLEEN ROSE (CNP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ROSE
Last Name:THARP
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7595 COUNTY ROAD 236
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-8738
Mailing Address - Country:US
Mailing Address - Phone:419-427-1984
Mailing Address - Fax:
Practice Address - Street 1:7595 COUNTY ROAD 236
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-8738
Practice Address - Country:US
Practice Address - Phone:419-427-1984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN252134, NP06679363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2407345Medicaid
OHP00647936Medicare PIN
OHP89688Medicare UPIN
OHTHNP76981Medicare ID - Type Unspecified
OH2407345Medicaid
76981Medicare PIN