Healthcare Provider Details

I. General information

NPI: 1548563752
Provider Name (Legal Business Name): KATHRYN SAUMWEBER HOGAN CPM, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN SAUMWEBER CPM, LM

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 44TH AVE S
MINNEAPOLIS MN
55406-3540
US

IV. Provider business mailing address

4201 44TH AVE S
MINNEAPOLIS MN
55406-3540
US

V. Phone/Fax

Practice location:
  • Phone: 651-335-1283
  • Fax:
Mailing address:
  • Phone: 651-335-1283
  • Fax: 888-503-3229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number113-49
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1025
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: