Provider Demographics
NPI:1578176251
Name:MCGUIRE, KATHERINE ALICE
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ALICE
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 GEORGE ST STE J
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2648
Mailing Address - Country:US
Mailing Address - Phone:304-929-2670
Mailing Address - Fax:
Practice Address - Street 1:76 CASHION ST
Practice Address - Street 2:
Practice Address - City:ANSTED
Practice Address - State:WV
Practice Address - Zip Code:25812-8006
Practice Address - Country:US
Practice Address - Phone:681-422-2720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant