Provider Demographics
NPI:1710227053
Name:DENNIS, KATRIS (LPN)
Entity Type:Individual
Prefix:
First Name:KATRIS
Middle Name:
Last Name:DENNIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 BISHOPSGATE DR
Mailing Address - Street 2:APT 114
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4347
Mailing Address - Country:US
Mailing Address - Phone:513-477-5831
Mailing Address - Fax:
Practice Address - Street 1:95 BISHOPSGATE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4347
Practice Address - Country:US
Practice Address - Phone:513-477-5831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-23
Last Update Date:2013-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.140293-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse