Ethridge, Katie Taylor

Ethridge, Katie Taylor is an individual health care provider with primary practice located at 179 Station Place Way Suite 100, Hurricane WV 25526-8747. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Ethridge, Katie Taylor can be contacted via phone (304) 760-6300.

Contact Information

Primary practice address
179 Station Place Way Suite 100 Hurricane WV 25526-8747
Phone: (304) 760-6300
Fax: (304) 201-5123
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 1310 West Virginia

Profile Details

NPI number 1518183508
LBN Legal business name Ethridge, Katie Taylor
Credentials MOT, OTRL
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2007
Last updated May 14th, 2012 - about 12 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 1518183508 NPPES
District of Columbia Other JL75-0029 BCBS PROVIDER NUMBER
District of Columbia Other 890362-01 BCBS PROVIDER NUMBER

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