Provider Demographics
NPI:1801370812
Name:KOHL, CATHERINE MOLLY
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MOLLY
Last Name:KOHL
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 1:2140 ROBIN DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-6912
Mailing Address - Country:US
Mailing Address - Phone:334-740-4647
Mailing Address - Fax:
Practice Address - Street 1:1907 S COLLEGE ST STE 201
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-5906
Practice Address - Country:US
Practice Address - Phone:334-203-6196
Practice Address - Fax:334-231-5093
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-078769363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily