1447502356 NPI number — KATELYN S WHETSTONE DPT

Table of content: KATELYN S WHETSTONE DPT (NPI 1447502356)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447502356 NPI number — KATELYN S WHETSTONE DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHETSTONE
Provider First Name:
KATELYN
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447502356
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7300 E INDIANA ST
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
EVANSVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47715-2794
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-476-0409
Provider Business Mailing Address Fax Number:
812-476-1016

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
425B W JENNINGS ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWBURGH
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47630-1113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-518-3246
Provider Business Practice Location Address Fax Number:
812-518-3268
Provider Enumeration Date:
10/03/2012

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: 225100000X , with the licence number:  05010934A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 201121590 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000793296 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000798336 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com