Basic Information
Provider Information
NPI: 1033273636
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DELLINGER
FirstName: KATHERINE
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HENDLEY
OtherFirstName: KATHERINE
OtherMiddleName: D
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 415 N CENTER ST
Address2: SUITE 201
City: HICKORY
State: NC
PostalCode: 286015036
CountryCode: US
TelephoneNumber: 8283278105
FaxNumber: 8283274245
Practice Location
Address1: 415 N CENTER ST
Address2: SUITE 201
City: HICKORY
State: NC
PostalCode: 286015036
CountryCode: US
TelephoneNumber: 8283278105
FaxNumber: 8283274245
Other Information
ProviderEnumerationDate: 12/20/2006
LastUpdateDate: 03/06/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X197730NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

ID Information
IDTypeStateIssuerDescription
805269305NC MEDICAID


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