MEDICARE: KATHERINE M WALDRON

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	390200000X	Student in an Organized Health Care Education/Training Program
2	2255A2300X	Athletic Trainer	AT007207	OH

General Provider Information

NPI Number	:	1831931591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE M WALDRON

Provider Business Mailing Address
First Line	:	1037 OAK AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-2723
Country	:	US
Telephone Number	:	513-607-2551
Fax Number	:

Provider Business Practice Location Address
First Line	:	1037 OAK AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-2723
Country	:	US
Telephone Number	:	513-607-2551
Fax Number	:

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

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	07/31/2025

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Directions to “ KATHERINE M WALDRON ” Practice Location

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