Provider Demographics
NPI:1528860665
Name:DOUGLAS, KATIE LOUISE (DOULA)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:LOUISE
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3756 WILLIAMSON RD NW APT Q
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-3330
Mailing Address - Country:US
Mailing Address - Phone:509-342-4752
Mailing Address - Fax:
Practice Address - Street 1:3756 WILLIAMSON RD NW APT Q
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-3330
Practice Address - Country:US
Practice Address - Phone:509-342-4752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4994374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula