Provanzana, Kathleen Michelle

Provanzana, Kathleen Michelle is an individual health care provider with primary practice located at 6 Lexington Blvd , Delaware OH 43015-1047. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Provanzana, Kathleen Michelle can be contacted via phone (740) 363-3305.

Contact Information

Primary practice address
6 Lexington Blvd Delaware OH 43015-1047
Phone: (740) 363-3305
Fax: (740) 383-7942
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35071152P Ohio

Profile Details

NPI number 1891736013
LBN Legal business name Provanzana, Kathleen Michelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Feb 20th, 2024 - about 9 months 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 1891736013 NPPES
Other 2025334 AETNA
Other 311098079 AETNA
Other 311098079 AETNA
Other 311098079240 AETNA
Other 0104351 AETNA
Other 080122321 AETNA
MEDICAID 2074133 AETNA
Other 0855442 AETNA
Other 353077 AETNA

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