Healthcare Provider Details

I. General information

NPI: 1700747433
Provider Name (Legal Business Name): KATRINA SCAGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5559 RAIDERS RD
FRAZEYSBURG OH
43822-9431
US

IV. Provider business mailing address

841 STEUBENVILLE AVE
CAMBRIDGE OH
43725-2301
US

V. Phone/Fax

Practice location:
  • Phone: 855-692-7247
  • Fax: 855-692-7247
Mailing address:
  • Phone: 855-692-7247
  • Fax: 855-692-7247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberCDCA.192828
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: