Provider Demographics
NPI:1902809098
Name:HANEY, KATHERINE CLARKE (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CLARKE
Last Name:HANEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:L
Other - Last Name:CLARKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 440222
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0222
Mailing Address - Country:US
Mailing Address - Phone:615-329-1242
Mailing Address - Fax:615-329-1235
Practice Address - Street 1:2201 MURPHY AVE STE 407
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1864
Practice Address - Country:US
Practice Address - Phone:615-342-6880
Practice Address - Fax:615-986-5959
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35028207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH43184Medicare UPIN