Kathleen Averre
Individual provider Active NPI Specialist · Parma, OH
NPI 1154733996 · NPPES record last updated May 28, 2014
Key facts
- NPI
- 1154733996
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- OH1453857 (OH)
- Practice address
- 7700 Malibu Dr
Parma, OH 44130-7203 - Phone
- (216) 885-3770
- NPI assigned
- May 28, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OH1453857 | OH | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | OH1453857 | OH | Yes |
Addresses
Primary practice location
7700 Malibu Dr
Parma, OH 44130-7203
Mailing address
7700 Malibu Dr
Parma, OH 44130-7203
Phone (216) 885-3770
Other providers in Parma, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.