Individual
KATHERINE ANN CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4918 MABLE ST, CORPUS CHRISTI, TX 78411-4029
(361) 933-6399
(361) 933-6399
Mailing address
3950 CYPRESS WOOD CT, FORT WORTH, TX 76133-6815
(361) 933-6399
(682) 499-6952
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
513969099
—
TX
01
—
5A10-E24-KC21
PESTIGE
TX
Enumeration date
01/29/2020
Last updated
04/17/2023
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