Healthcare Provider Details
I. General information
NPI: 1316947203
Provider Name (Legal Business Name): NINA J KLEINBERG CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/21/2005
Last Update Date: 02/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
230 MAPLE STREET SUITE 200 MIDWIFERY CARE OF HOLYOKE
HOLYOKE MA
01040
US
IV. Provider business mailing address
WESTERN MASS PHYSICIAN ASSOCIATES INC 260 NEW LUDLOW RD
CHICOPEE MA
01020
US
V. Phone/Fax
- Phone: 413-535-4700
- Fax: 413-535-4704
- Phone: 413-533-3470
- Fax: 413-533-6859
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | 188294 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: