Provider Demographics
NPI:1730547084
Name:CATLIN, CHARITY (LM, CPM)
Entity type:Individual
Prefix:MRS
First Name:CHARITY
Middle Name:
Last Name:CATLIN
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2355
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-2355
Mailing Address - Country:US
Mailing Address - Phone:208-627-8096
Mailing Address - Fax:844-661-1057
Practice Address - Street 1:819 HIGHWAY 2 STE 214
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1678
Practice Address - Country:US
Practice Address - Phone:208-627-8096
Practice Address - Fax:844-661-1057
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMID-64176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1730547084Medicaid