Provider Demographics
NPI:1164887790
Name:MARTIN, CATHERINE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:LIGHTFOOT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1542 WOODSON RD
Mailing Address - Street 2:
Mailing Address - City:BALDWIN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66006-9221
Mailing Address - Country:US
Mailing Address - Phone:816-520-2247
Mailing Address - Fax:
Practice Address - Street 1:1542 WOODSON RD
Practice Address - Street 2:
Practice Address - City:BALDWIN CITY
Practice Address - State:KS
Practice Address - Zip Code:66006-9221
Practice Address - Country:US
Practice Address - Phone:816-520-2247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-26
Last Update Date:2015-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife