Healthcare Provider Details

I. General information

NPI: 1144210675
Provider Name (Legal Business Name): KATHLEEN DENISE MCCARTHY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 03/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 W 7TH ST
WILMINGTON DE
19805-3110
US

IV. Provider business mailing address

2300 GARFIELD AVE WILMINGTON
WILMINGTON DE
19809-1212
US

V. Phone/Fax

Practice location:
  • Phone: 302-658-2229
  • Fax: 302-658-2382
Mailing address:
  • Phone: 302-658-2229
  • Fax: 302-658-2382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberLK0000120
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: