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:
Health care specialties
| Specialty | Code | License # | 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 last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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