MEDICARE: KATHERINE JISEL MAROUN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	172V00000X	Community Health Worker
2	174H00000X	Health Educator
3	374J00000X	Doula
4	133N00000X	Nutritionist
5	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1134915697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE JISEL MAROUN

Provider Business Mailing Address
First Line	:	9846 DAISY AVE
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4719
Country	:	US
Telephone Number	:	561-543-9479
Fax Number	:

Provider Business Practice Location Address
First Line	:	9846 DAISY AVE
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4719
Country	:	US
Telephone Number	:	561-543-9479
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2025
Last Update Date	:	04/18/2025

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