Healthcare Provider Details

I. General information

NPI: 1891548277
Provider Name (Legal Business Name): OMNI KATHERINE KITTS FERRARA RN, DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 04/08/2024
Certification Date: 04/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2279 BECKHAM DR NE
RIO RANCHO NM
87144-1472
US

IV. Provider business mailing address

2279 BECKHAM DR NE
RIO RANCHO NM
87144-1472
US

V. Phone/Fax

Practice location:
  • Phone: 505-600-1464
  • Fax:
Mailing address:
  • Phone: 973-864-7098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number75560
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number75560
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: