Provider Demographics
NPI:1679775118
Name:MAZZARA, KATHERYN NOREEN (CPM)
Entity Type:Individual
Prefix:MRS
First Name:KATHERYN
Middle Name:NOREEN
Last Name:MAZZARA
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 S HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-6156
Mailing Address - Country:US
Mailing Address - Phone:810-333-1325
Mailing Address - Fax:
Practice Address - Street 1:1020 S HILLS DR
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-6156
Practice Address - Country:US
Practice Address - Phone:810-333-1325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife