Provider Demographics
NPI:1649541236
Name:LINDSEY, KATHERINE COWINS (PT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:COWINS
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 WAVERLY LANE
Mailing Address - Street 2:
Mailing Address - City:LANEXA
Mailing Address - State:VA
Mailing Address - Zip Code:23089-9124
Mailing Address - Country:US
Mailing Address - Phone:757-566-8132
Mailing Address - Fax:
Practice Address - Street 1:1701 WAVERLY LANE
Practice Address - Street 2:
Practice Address - City:LANEXA
Practice Address - State:VA
Practice Address - Zip Code:23089-9124
Practice Address - Country:US
Practice Address - Phone:757-566-8132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305001217172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker