Provider Demographics
NPI:1700337623
Name:ADRIAN, KATHERINE (MPH, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:ADRIAN
Suffix:
Gender:F
Credentials:MPH, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 BELHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:HOLLY RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28445-7525
Mailing Address - Country:US
Mailing Address - Phone:760-495-2422
Mailing Address - Fax:
Practice Address - Street 1:415 BELHAVEN CT
Practice Address - Street 2:
Practice Address - City:HOLLY RIDGE
Practice Address - State:NC
Practice Address - Zip Code:28445-7525
Practice Address - Country:US
Practice Address - Phone:760-495-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-14
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer