MEDICARE: MS. KATHY ANN SYKORA LPN

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
1	163W00000X	Registered Nurse	RN.437204	OH
2	164W00000X	Licensed Practical Nurse	PN 139934-M-IV	OH

General Provider Information

NPI Number	:	1831400571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHY ANN SYKORA LPN

Provider Business Mailing Address
First Line	:	100 CROWNE POINT PL
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45241-5427
Country	:	US
Telephone Number	:	513-743-7628
Fax Number	:

Provider Business Practice Location Address
First Line	:	3103 DIXIE HWY
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45015-1653
Country	:	US
Telephone Number	:	513-892-4673
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	10/30/2023

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