Provider Demographics
NPI:1952727117
Name:BARBEHENN, KATHRYN IRENE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:IRENE
Last Name:BARBEHENN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 CHAMPLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754-1650
Mailing Address - Country:US
Mailing Address - Phone:845-807-7061
Mailing Address - Fax:
Practice Address - Street 1:117 CHAMPLIN AVE
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-1650
Practice Address - Country:US
Practice Address - Phone:845-807-7061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY551275-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse