Provider Demographics
NPI:1891304234
Name:KITCHENS, CATRINA D
Entity Type:Individual
Prefix:
First Name:CATRINA
Middle Name:D
Last Name:KITCHENS
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 1:212 N BIERDEMAN RD
Mailing Address - Street 2:
Mailing Address - City:PEARL
Mailing Address - State:MS
Mailing Address - Zip Code:39208-4611
Mailing Address - Country:US
Mailing Address - Phone:601-715-4972
Mailing Address - Fax:
Practice Address - Street 1:212 N BIERDEMAN RD
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-4611
Practice Address - Country:US
Practice Address - Phone:601-715-4972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)