Provider Demographics
NPI:1174380083
Name:FORGUES, KATHIE
Entity type:Individual
Prefix:
First Name:KATHIE
Middle Name:
Last Name:FORGUES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4138 NW 88TH AVE APT 106
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-1857
Mailing Address - Country:US
Mailing Address - Phone:954-778-3819
Mailing Address - Fax:
Practice Address - Street 1:4138 NW 88TH AVE APT 106
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-1857
Practice Address - Country:US
Practice Address - Phone:954-778-3819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL202402371374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula