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NPI Code Detail

MEDICARE: KATELYN MARIE CLEAVES

MEDICARE: KATELYN MARIE CLEAVES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1093663965
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN MARIE CLEAVES
Provider Business Mailing Address
First Line : PO BOX 738
Second Line :
City : BOWLING GREEN
State : OH
Zip : 43402-0738
Country : US
Telephone Number : 419-352-7588
Fax Number :
Provider Business Practice Location Address
First Line : 1045 KLOTZ RD
Second Line :
City : BOWLING GREEN
State : OH
Zip : 43402-4820
Country : US
Telephone Number : 419-352-7588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2026
Last Update Date : 03/17/2026

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Directions to “ KATELYN MARIE CLEAVES ” Practice Location

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