Provider Demographics
NPI:1861257024
Name:BROOKHART, KATHY
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:
Last Name:BROOKHART
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 1:4075 SAW MILL CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-2107
Mailing Address - Country:US
Mailing Address - Phone:216-536-7734
Mailing Address - Fax:
Practice Address - Street 1:4075 SAW MILL CIR
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-2107
Practice Address - Country:US
Practice Address - Phone:216-536-7734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker