Provider Demographics
NPI:1649959446
Name:BOSWELL, KATRINA GARCIA (DOULA)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:GARCIA
Last Name:BOSWELL
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:MARIE
Other - Last Name:BOSWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20652 BLANCA DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7063
Mailing Address - Country:US
Mailing Address - Phone:805-234-2173
Mailing Address - Fax:
Practice Address - Street 1:20652 BLANCA DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7063
Practice Address - Country:US
Practice Address - Phone:805-234-2173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula