Healthcare Provider Details

I. General information

NPI: 1669868311
Provider Name (Legal Business Name): HADASSAH KATZ CNM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2651 E DISCOVERY PKWY
BLOOMINGTON IN
47408-9059
US

IV. Provider business mailing address

2651 E DISCOVERY PKWY
BLOOMINGTON IN
47408-9059
US

V. Phone/Fax

Practice location:
  • Phone: 812-918-3400
  • Fax:
Mailing address:
  • Phone: 812-360-4514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW 307
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number71016910A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: