MEDICARE: MRS. DOROTHY S. KIRKPATRICK RM, CPM

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	57	CO

General Provider Information

NPI Number	:	1093746745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DOROTHY S. KIRKPATRICK RM, CPM

Provider Business Mailing Address
First Line	:	1526 W COLORADO AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-4027
Country	:	US
Telephone Number	:	719-660-2743
Fax Number	:	719-533-0919

Provider Business Practice Location Address
First Line	:	1526 W COLORADO AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-4027
Country	:	US
Telephone Number	:	719-660-2743
Fax Number	:	719-533-0919

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	09/23/2014

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