Provider Demographics
NPI:1437358090
Name:DECHO, KATHERINE (RN BSN CWOCN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:DECHO
Suffix:
Gender:F
Credentials:RN BSN CWOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 TAYLOR STREET SUITE 4-E
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29220
Mailing Address - Country:US
Mailing Address - Phone:803-296-8906
Mailing Address - Fax:803-296-8908
Practice Address - Street 1:1333 TAYLOR STREET SUITE 4-E
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29220
Practice Address - Country:US
Practice Address - Phone:803-296-8906
Practice Address - Fax:803-296-8908
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRN44073163WE0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCRN 44073OtherSTATE RN LICENSE