Provider Demographics
NPI:1083149835
Name:CORDELL, KATHRYN (PROFESSIONAL DOULA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:CORDELL
Suffix:
Gender:F
Credentials:PROFESSIONAL DOULA
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 662
Mailing Address - Street 2:
Mailing Address - City:GATESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76528-0662
Mailing Address - Country:US
Mailing Address - Phone:254-216-9394
Mailing Address - Fax:
Practice Address - Street 1:2400 GREENBRIAR ROAD
Practice Address - Street 2:
Practice Address - City:GATESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76528
Practice Address - Country:US
Practice Address - Phone:254-216-9394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist