Provider Demographics
NPI:1538261391
Name:PULS, KATHERINE STICK (CNM/APN)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:STICK
Last Name:PULS
Suffix:
Gender:F
Credentials:CNM/APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 BABETTA AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-2308
Mailing Address - Country:US
Mailing Address - Phone:847-698-0198
Mailing Address - Fax:847-864-1208
Practice Address - Street 1:712 BABETTA AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-2308
Practice Address - Country:US
Practice Address - Phone:847-698-0198
Practice Address - Fax:847-864-1208
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife