Herren, Kathy A

Herren, Kathy A is an sole proprietor health care provider with primary practice located at 3412 Office Park Drive , Marion IL 62959. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Herren, Kathy A can be contacted via phone (618) 993-0404.

Contact Information

Primary practice address
3412 Office Park Drive Marion IL 62959
Phone: (618) 993-0404
Fax: (618) 993-1717
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085002634 Illinois

Profile Details

NPI number 1740337237
LBN Legal business name Herren, Kathy A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 5th, 2007
Last updated May 23rd, 2019 - about 6 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 1740337237 NPPES
Illinois Other 080129117 RAILROAD MEDICARE
Illinois Other 174143 RAILROAD MEDICARE
Illinois Other 10019630 RAILROAD MEDICARE
Illinois Other E26544 RAILROAD MEDICARE
Illinois MEDICAID 143870 RAILROAD MEDICARE
Illinois Other 043448 RAILROAD MEDICARE

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