Provider Demographics
NPI:1306698220
Name:REISING, KATERI T
Entity type:Individual
Prefix:
First Name:KATERI
Middle Name:T
Last Name:REISING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1381 W OHIO PIKE APT 4E
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-1348
Mailing Address - Country:US
Mailing Address - Phone:859-547-6332
Mailing Address - Fax:
Practice Address - Street 1:1381 W OHIO PIKE APT 4E
Practice Address - Street 2:
Practice Address - City:AMELIA
Practice Address - State:OH
Practice Address - Zip Code:45102-1348
Practice Address - Country:US
Practice Address - Phone:859-547-6332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty