Provider Demographics
NPI:1902235831
Name:THEURI, KATHERINE KIRIGO
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:KIRIGO
Last Name:THEURI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 7TH AVE
Mailing Address - Street 2:NORTHWESTERN ALABAMA MENTAL HEALTH CENTER
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-4329
Mailing Address - Country:US
Mailing Address - Phone:205-302-9000
Mailing Address - Fax:
Practice Address - Street 1:1100 7TH AVE
Practice Address - Street 2:NORTHWESTERN ALABAMA MENTAL HEALTH CENTER
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-4329
Practice Address - Country:US
Practice Address - Phone:205-387-0541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-108692363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health