Provider Demographics
NPI:1750386967
Name:HEMKER, KATHRYN A (PHD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:HEMKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:H
Other - Last Name:BOBBITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:20415 GULF VICTORY WAY
Mailing Address - Street 2:
Mailing Address - City:FORT BLISS
Mailing Address - State:TX
Mailing Address - Zip Code:79918-8066
Mailing Address - Country:US
Mailing Address - Phone:304-834-4303
Mailing Address - Fax:
Practice Address - Street 1:20415 GULF VICTORY WAY
Practice Address - Street 2:
Practice Address - City:FORT BLISS
Practice Address - State:TX
Practice Address - Zip Code:79918-8066
Practice Address - Country:US
Practice Address - Phone:304-834-4303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5239103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2186307Medicaid
WV9201027000Medicaid
S02641Medicare UPIN
CP28832Medicare ID - Type Unspecified