Provider Demographics
NPI:1649328105
Name:ACREE, KATHY S (LM,CPM)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:S
Last Name:ACREE
Suffix:
Gender:F
Credentials:LM,CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 STEINER RD
Mailing Address - Street 2:APT 117
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6000
Mailing Address - Country:US
Mailing Address - Phone:337-993-8190
Mailing Address - Fax:337-706-7163
Practice Address - Street 1:183 STEINER RD
Practice Address - Street 2:APT 117
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6000
Practice Address - Country:US
Practice Address - Phone:337-993-8190
Practice Address - Fax:337-706-7163
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMW0391176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife