Kathryn Zalla

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Villa Hills, KY

NPI 1639969009 · NPPES record last updated May 8, 2025

Key facts

NPI
1639969009
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1018 Colina Dr
Villa Hills, KY 41017-5322
Phone
(859) 426-7351
NPI assigned
May 8, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260604001533 TN Order and Referring Only - Dermatology
Practitioner - Dermatology
8921579509

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1018 Colina Dr
Villa Hills, KY 41017-5322

Mailing address

1018 Colina Dr
Villa Hills, KY 41017-5322

Other providers in Villa Hills, KY

All providers in Villa Hills, KY · Student in an Organized Health Care Education/Training Program in Kentucky

Sources for this page

Verify at the official NPI Registry.