Healthcare Provider Details
I. General information
NPI: 1093746745
Provider Name (Legal Business Name): DOROTHY S. KIRKPATRICK RM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/05/2006
Last Update Date: 09/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1526 W COLORADO AVE
COLORADO SPRINGS CO
80904-4027
US
IV. Provider business mailing address
1526 W COLORADO AVE
COLORADO SPRINGS CO
80904-4027
US
V. Phone/Fax
- Phone: 719-660-2743
- Fax: 719-533-0919
- Phone: 719-660-2743
- Fax: 719-533-0919
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 176B00000X |
| Taxonomy | Midwife |
| License Number | 57 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: