Provider Demographics
NPI:1316820905
Name:KATH, ANDREA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:KATH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:HANKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58041-0013
Mailing Address - Country:US
Mailing Address - Phone:701-640-7897
Mailing Address - Fax:
Practice Address - Street 1:416 1ST AVE SW
Practice Address - Street 2:
Practice Address - City:HANKINSON
Practice Address - State:ND
Practice Address - Zip Code:58041-4404
Practice Address - Country:US
Practice Address - Phone:701-640-7897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver