Provider Demographics
NPI:1710585179
Name:MCGLONE, CATHY L
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:L
Last Name:MCGLONE
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 1:1825 EVLINE DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44904-1722
Mailing Address - Country:US
Mailing Address - Phone:419-775-6625
Mailing Address - Fax:
Practice Address - Street 1:1825 EVLINE DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44904-1722
Practice Address - Country:US
Practice Address - Phone:419-775-6625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No347C00000XTransportation ServicesPrivate Vehicle