Provider Demographics
NPI:1457059461
Name:KELLY-THOMAS, KATELIN (DOULA)
Entity Type:Individual
Prefix:
First Name:KATELIN
Middle Name:
Last Name:KELLY-THOMAS
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10220
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87184-0220
Mailing Address - Country:US
Mailing Address - Phone:760-803-6141
Mailing Address - Fax:
Practice Address - Street 1:6742 ELWOOD DR NW
Practice Address - Street 2:
Practice Address - City:LOS RANCHOS
Practice Address - State:NM
Practice Address - Zip Code:87107-6109
Practice Address - Country:US
Practice Address - Phone:760-803-6141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula