Provider Demographics
NPI:1568721009
Name:CHUMLEY, KATIE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:CHUMLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 EAST BROADWAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501
Mailing Address - Country:US
Mailing Address - Phone:701-328-8888
Mailing Address - Fax:701-328-8900
Practice Address - Street 1:101 EAST BROADWAY AVENUE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501
Practice Address - Country:US
Practice Address - Phone:701-222-0386
Practice Address - Fax:701-255-4891
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator