Provider Demographics
NPI:1700983335
Name:STEVENSON, CATHRINE (MS)
Entity Type:Individual
Prefix:
First Name:CATHRINE
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CLINIC DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-1661
Mailing Address - Country:US
Mailing Address - Phone:270-825-7200
Mailing Address - Fax:
Practice Address - Street 1:800 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-1658
Practice Address - Country:US
Practice Address - Phone:270-326-4800
Practice Address - Fax:270-326-4968
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0387231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0387OtherLICENSE
KY70000344Medicaid
000000189846OtherBCBS PROVIDER NUMBER
0684407Medicare PIN
KYK078550Medicare PIN
KY040014386Medicare PIN
0600242Medicare PIN
KY0387OtherLICENSE
C64362Medicare UPIN
KYP400021318Medicare PIN
000000189846OtherBCBS PROVIDER NUMBER
KY70000344Medicaid
0570269Medicare PIN