MEDICARE: KATHERINE DEVINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	6687	TN

General Provider Information

NPI Number	:	1518572833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE DEVINE

Provider Business Mailing Address
First Line	:	1713 BEECHWOOD AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-5501
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1713 BEECHWOOD AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-5501
Country	:	US
Telephone Number	:	270-799-8782
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2020
Last Update Date	:	09/14/2020

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Directions to “ KATHERINE DEVINE ” Practice Location

Language	Start Address	Practice Location

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