Provider Demographics
NPI:1336897032
Name:BREIDING, KATE AVALEE
Entity Type:Individual
Prefix:MISS
First Name:KATE
Middle Name:AVALEE
Last Name:BREIDING
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 1:624 FRAZEE AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-1922
Mailing Address - Country:US
Mailing Address - Phone:330-907-9898
Mailing Address - Fax:
Practice Address - Street 1:624 FRAZEE AVE APT 10
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-1922
Practice Address - Country:US
Practice Address - Phone:330-907-9898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-13
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemaker