Provider Demographics
NPI:1265788939
Name:HEWITT, KATE ANN (PT)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:ANN
Last Name:HEWITT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:ANN
Other - Last Name:ENGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1268 PERRY AVE
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-2115
Mailing Address - Country:US
Mailing Address - Phone:231-796-4419
Mailing Address - Fax:231-796-4980
Practice Address - Street 1:1268 PERRY AVE
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-2115
Practice Address - Country:US
Practice Address - Phone:231-796-4419
Practice Address - Fax:231-796-4980
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015910225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist