Provider Demographics
NPI:1063230670
Name:SNOWBALL, CATHY SMITH (RN, BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:SMITH
Last Name:SNOWBALL
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 LIFFORD LN UNIT 211
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-5128
Mailing Address - Country:US
Mailing Address - Phone:801-834-4191
Mailing Address - Fax:
Practice Address - Street 1:1001 LIFFORD LN UNIT 211
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-5128
Practice Address - Country:US
Practice Address - Phone:801-834-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN281192163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant