Healthcare Provider Details

I. General information

NPI: 1366634271
Provider Name (Legal Business Name): KATHERINE PEPPERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 08/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3323 DESERETTE LN
COLUMBUS OH
43224-3780
US

IV. Provider business mailing address

3323 DESERETTE LN
COLUMBUS OH
43224-3780
US

V. Phone/Fax

Practice location:
  • Phone: 614-374-1870
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: