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General NPI Number Information
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NPI Number | 1669486791
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Entity Type | Individual
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Provider Name | KATHRYN MARY PREVOST AU.D.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 393 ROOSEVELT AVE E
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City | BATTLE CREEK
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State | MI
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Zip | 49017-3333
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Country | US
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Telephone | 586-243-3246
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Fax | 269-441-4150
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Provider Business Mailing Address
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Address Line | 201 FULTON ST W APT. 1216
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-6201
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Country | US
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Telephone | 616-855-6207
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1601000171
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License Number State | MI
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