Provider Demographics
NPI:1770969248
Name:MASIN, KATHERINE (CRNA)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:MASIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:SUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1753 GOLDENROD CT
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036
Mailing Address - Country:US
Mailing Address - Phone:937-545-2899
Mailing Address - Fax:
Practice Address - Street 1:7661 BEECHMONT AVE
Practice Address - Street 2:STE 120
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4234
Practice Address - Country:US
Practice Address - Phone:513-231-9010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH019369367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered