Healthcare Provider Details

I. General information

NPI: 1194449660
Provider Name (Legal Business Name): ANGELA KINDER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 GORDON GUTMANN BLVD STE 201
JEFFERSONVILLE IN
47130-3766
US

IV. Provider business mailing address

301 GORDON GUTMANN BLVD STE 201
JEFFERSONVILLE IN
47130-3766
US

V. Phone/Fax

Practice location:
  • Phone: 812-282-6114
  • Fax:
Mailing address:
  • Phone: 812-282-6114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number09000405A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: