Provider Demographics
NPI:1043214604
Name:DESPOT, KATY (CNM)
Entity Type:Individual
Prefix:MS
First Name:KATY
Middle Name:
Last Name:DESPOT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 SILVER LN
Mailing Address - Street 2:STE 2A
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-5343
Mailing Address - Country:US
Mailing Address - Phone:203-386-0044
Mailing Address - Fax:203-377-4156
Practice Address - Street 1:999 SILVER LN
Practice Address - Street 2:STE 2A
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-5343
Practice Address - Country:US
Practice Address - Phone:203-386-0044
Practice Address - Fax:203-377-4156
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000034176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife