Provider Demographics
NPI:1982310223
Name:NAGEL, KATIE (MSN, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:NAGEL
Suffix:
Gender:F
Credentials:MSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8112 SHARON JEAN DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2085
Mailing Address - Country:US
Mailing Address - Phone:817-905-6236
Mailing Address - Fax:
Practice Address - Street 1:8112 SHARON JEAN DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2085
Practice Address - Country:US
Practice Address - Phone:817-905-6236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-41846174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN