Provider Demographics
NPI:1255155677
Name:WHITAKER, KATHERYNE
Entity type:Individual
Prefix:
First Name:KATHERYNE
Middle Name:
Last Name:WHITAKER
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 1:395 TRADEWIND CT
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3503
Mailing Address - Country:US
Mailing Address - Phone:614-674-4455
Mailing Address - Fax:
Practice Address - Street 1:3300 SHILOH SPRINGS RD APT 123
Practice Address - Street 2:
Practice Address - City:TROTWOOD
Practice Address - State:OH
Practice Address - Zip Code:45426-2290
Practice Address - Country:US
Practice Address - Phone:614-674-4455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty