Healthcare Provider Details

I. General information

NPI: 1851185409
Provider Name (Legal Business Name): KATHY MARIE CRUMES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4898 GUERLEY RD
CINCINNATI OH
45238-4038
US

IV. Provider business mailing address

222 PLEASANT ST
COVINGTON KY
41011-3416
US

V. Phone/Fax

Practice location:
  • Phone: 513-435-0379
  • Fax:
Mailing address:
  • Phone: 513-609-3195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: