Healthcare Provider Details

I. General information

NPI: 1609856228
Provider Name (Legal Business Name): KRISTIN A DONEWALD CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8640 TOZER CT
PORTAGE MI
49024-4798
US

IV. Provider business mailing address

8640 TOZER CT
PORTAGE MI
49024-4798
US

V. Phone/Fax

Practice location:
  • Phone: 269-341-7979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number4704194038
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: