Healthcare Provider Details

I. General information

NPI: 1053081224
Provider Name (Legal Business Name): CATHERINE CRESWELL NP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE CICCHETTO NP, CNM

II. Dates (important events)

Enumeration Date: 09/17/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OLATHE BLVD LEVEL 5B AND 5C
KANSAS CITY KS
66160-2135
US

IV. Provider business mailing address

2000 OLATHE BLVD MEDICAL PAVILION OFFICES OBGYN OFFICE
KANSAS CITY KS
66160-0001
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: