Healthcare Provider Details

I. General information

NPI: 1669309712
Provider Name (Legal Business Name): KATHERINE MARIE ALSIP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHERINE GUARISCO ALSIP RN

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 OLD COUNTY RD
DAPHNE AL
36526-4427
US

IV. Provider business mailing address

1320 OLD COUNTY RD
DAPHNE AL
36526-4427
US

V. Phone/Fax

Practice location:
  • Phone: 251-626-9242
  • Fax:
Mailing address:
  • Phone: 251-626-9242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-042518
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: