Provider Demographics
NPI:1588926489
Name:PIKE, KATHRYN JEANNE
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:JEANNE
Last Name:PIKE
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 1:3469 MULBERRY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7532
Mailing Address - Country:US
Mailing Address - Phone:435-674-5499
Mailing Address - Fax:
Practice Address - Street 1:474 W 200 N
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4505
Practice Address - Country:US
Practice Address - Phone:435-634-5660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other