Provider Demographics
NPI:1811666944
Name:GORBOLD, KATIE CHRISTINA (APRN-CNM)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:CHRISTINA
Last Name:GORBOLD
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2671 HADDAM RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1531
Mailing Address - Country:US
Mailing Address - Phone:815-953-6333
Mailing Address - Fax:
Practice Address - Street 1:9176 WINESBURG RD
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:OH
Practice Address - Zip Code:44624-9437
Practice Address - Country:US
Practice Address - Phone:330-359-0580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-11
Last Update Date:2021-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife