Provider Demographics
NPI:1205646924
Name:PAULK, CATHY A
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:A
Last Name:PAULK
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 1:505 N FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NE
Mailing Address - Zip Code:68938-1914
Mailing Address - Country:US
Mailing Address - Phone:402-303-0608
Mailing Address - Fax:
Practice Address - Street 1:31040 ROAD L
Practice Address - Street 2:
Practice Address - City:CLAY CENTER
Practice Address - State:NE
Practice Address - Zip Code:68933-3334
Practice Address - Country:US
Practice Address - Phone:402-303-0608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant