Provider Demographics
NPI:1265825491
Name:KORMANN, KATERI
Entity Type:Individual
Prefix:
First Name:KATERI
Middle Name:
Last Name:KORMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 S HOLCOMBE AVE
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55355-3011
Mailing Address - Country:US
Mailing Address - Phone:313-600-0368
Mailing Address - Fax:
Practice Address - Street 1:521 S HOLCOMBE AVE
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55355-3011
Practice Address - Country:US
Practice Address - Phone:313-600-0368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8730 DONA INTERNATIO374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula