Kathryn Debra Trevor, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

P38324 Issued in IA

Practice address

2979 Victoria St
Bettendorf, IA 52722-2784

Phone

(563) 332-8528

NPI assigned

Jul 18, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kitty Debra Trevor Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1104171941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 KIMBERLY RD",
            "address_2": "#104",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224164",
            "telephone_number": "563-940-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 VICTORIA ST",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527222784",
            "telephone_number": "563-332-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVOR",
        "first_name": "KATHRYN",
        "middle_name": "DEBRA",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IA",
            "license": "P38324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KITTY",
            "last_name": "TREVOR",
            "middle_name": "DEBRA",
            "credential": "LPN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Bettendorf, IA
• Licensed Practical Nurse in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.