1336258532 NPI number — MRS. KATHERINE LYNN JONES PT ATC

Table of content: MRS. KATHERINE LYNN JONES PT ATC (NPI 1336258532)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336258532 NPI number — MRS. KATHERINE LYNN JONES PT ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
KATHERINE
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ANDERSON
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT ATC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336258532
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
249 WEST 2ND STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-269-8097
Provider Business Mailing Address Fax Number:
304-269-8187

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
249 WEST 2ND STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-269-8097
Provider Business Practice Location Address Fax Number:
304-269-8187
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: 001434 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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