Provider Demographics
NPI:1649152554
Name:HULL, KATELYN (CNM)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:HULL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12911 HOLSINGER BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-8648
Mailing Address - Country:US
Mailing Address - Phone:360-713-7150
Mailing Address - Fax:
Practice Address - Street 1:301 HEALTH PARK BLVD STE 219
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5795
Practice Address - Country:US
Practice Address - Phone:904-819-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife