Bloodworth, Katherine

Bloodworth, Katherine is an individual health care provider with primary practice located at 1501 Mcpherson Ave , Mount Vernon IL 62864-2831. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Bloodworth, Katherine can be contacted via phone (618) 241-1748.

Contact Information

Primary practice address
1501 Mcpherson Ave Mount Vernon IL 62864-2831
Phone: (618) 241-1748
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209005931 Illinois

Profile Details

NPI number 1154415008
LBN Legal business name Bloodworth, Katherine
Credentials MNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Nov 26th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154415008 NPPES
Illinois Other CG2264 RR MED GRP ID
Illinois Other P00635208 RR MED GRP ID

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