=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699131946
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KATHERINE A HART WESTPHAL, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/01/2016
-----------------------------------------------------
Last Update Date | 01/01/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1849 MEMORIAL BLVD
-----------------------------------------------------
City | MURFREESBORO
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37129-1522
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-890-7246
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1849 MEMORIAL BLVD
-----------------------------------------------------
City | MURFREESBORO
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37129-1522
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-890-7246
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. KATHERINE A HART WESTPHAL
-----------------------------------------------------
Credential | DDS, MDS
-----------------------------------------------------
Telephone | 901-569-9431
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number | 9017
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------