Provider Demographics
NPI:1437282530
Name:HEWITT, KATHY WEAVER (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:WEAVER
Last Name:HEWITT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 W PARKER RD STE A
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4649
Mailing Address - Country:US
Mailing Address - Phone:828-433-5171
Mailing Address - Fax:828-433-1127
Practice Address - Street 1:145 W PARKER RD STE A
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4649
Practice Address - Country:US
Practice Address - Phone:828-433-5171
Practice Address - Fax:828-433-1127
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13092251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3403404Medicaid
NC078T6OtherBCBS - THROUGH EMPLOYER
NC7211295Medicaid
NC126G6OtherBCBS -PRIVATE PROVIDER