1457582504 NPI number — MRS. KATHERINE LOUISE BROTHERS HOME HEALTH AIDE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457582504 NPI number — MRS. KATHERINE LOUISE BROTHERS HOME HEALTH AIDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROTHERS
Provider First Name:
KATHERINE
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
HOME HEALTH AIDE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCDERMOTT
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
LOUISE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457582504
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 W 14TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERCED
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95340-6116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-261-0008
Provider Business Mailing Address Fax Number:
209-384-0348

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 W 14TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERCED
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95340-6116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-261-0008
Provider Business Practice Location Address Fax Number:
209-384-0348
Provider Enumeration Date:
08/06/2009

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: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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