Provider Demographics
NPI:1114649886
Name:COURTOY, KATHRYN N
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:N
Last Name:COURTOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:N
Other - Last Name:COURTOY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CLD
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:GA
Mailing Address - Zip Code:30146-0215
Mailing Address - Country:US
Mailing Address - Phone:678-296-6885
Mailing Address - Fax:
Practice Address - Street 1:717 POLK ST NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-2125
Practice Address - Country:US
Practice Address - Phone:770-845-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula