Basic Information
| Provider Information | |||||||||
| NPI: | 1477573137 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KATER | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5910 LANDERBROOK DR | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | MAYFIELD HTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441246508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4406845865 | ||||||||
| FaxNumber: | 4404491555 | ||||||||
| Practice Location | |||||||||
| Address1: | 11100 EUCLID AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441061716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168448500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 02/26/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC3500X | RN-197038 | OH | Y | Nursing Service Providers | Registered Nurse | Cardiac Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 2328421 | 05 | OH | MEDICAID | P00122519 | 01 | OH | MCR RR | OTHER |