1598101081 NPI number — MRS. KATHERINE ANN MCALEE BCABA, LABA

Table of content: MRS. KATHERINE ANN MCALEE BCABA, LABA (NPI 1598101081)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598101081 NPI number — MRS. KATHERINE ANN MCALEE BCABA, LABA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCALEE
Provider First Name:
KATHERINE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BCABA, LABA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BIDWELL
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
BCABA, LABA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598101081
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12949 CENTRE PARK CIR APT 301
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HERNDON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20171-5981
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-328-6755
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12949 CENTRE PARK CIR APT 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HERNDON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20171-5981
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-328-6755
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/11/2013

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: 222Q00000X , with the licence number:  0134000003 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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