Provider Demographics
NPI:1881778058
Name:NEWKIRK, KATRINA MARIE
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:MARIE
Last Name:NEWKIRK
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:PO BOX 4571
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47724-0571
Mailing Address - Country:US
Mailing Address - Phone:812-868-0798
Mailing Address - Fax:812-868-0798
Practice Address - Street 1:1243 BOWDEN DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47725-6424
Practice Address - Country:US
Practice Address - Phone:812-868-0798
Practice Address - Fax:812-868-0798
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003290A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist