Individual
TINA CATHELYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1106 4TH AVE, MOLINE, IL 61265-1231
(563) 336-3000
(563) 327-2045
Mailing address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
(563) 327-2045
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
209-013475
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IA
05
—
PENDING
—
IL
Enumeration date
11/17/2015
Last updated
11/17/2015
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