Healthcare Provider Details

I. General information

NPI: 1629512397
Provider Name (Legal Business Name): ATARA KLEIN CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2016
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2807 CHESWOLDE RD
BALTIMORE MD
21209-3930
US

IV. Provider business mailing address

2807 CHESWOLDE RD
BALTIMORE MD
21209-3930
US

V. Phone/Fax

Practice location:
  • Phone: 443-845-1843
  • Fax:
Mailing address:
  • Phone: 443-845-1843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberDEM00041
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: