Provider Demographics
NPI:1871522870
Name:KILLIGREW, CATHERINE JEANNE (PT)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:JEANNE
Last Name:KILLIGREW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 E 86TH ST
Mailing Address - Street 2:SUITE 22 D
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1867
Mailing Address - Country:US
Mailing Address - Phone:317-566-1923
Mailing Address - Fax:317-566-1923
Practice Address - Street 1:1020 E 86TH ST
Practice Address - Street 2:SUITE 22 D
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1867
Practice Address - Country:US
Practice Address - Phone:317-566-1923
Practice Address - Fax:317-566-1923
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05000900A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000337318OtherANTHEM
IN34081OtherINDIANA HEALTH NETWORK
IN000009378869OtherPRIVATE HEALTHCARE SYSTEM
IN000009378869OtherPRIVATE HEALTHCARE SYSTEM