Healthcare Provider Details

I. General information

NPI: 1164726675
Provider Name (Legal Business Name): KATHRYN LEE HARTWELL CPM, NHCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2010
Last Update Date: 12/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 N STATE ST
CONCORD NH
03301-3224
US

IV. Provider business mailing address

254 N STATE ST
CONCORD NH
03301-3224
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-8710
  • Fax:
Mailing address:
  • Phone: 603-228-8710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1039
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: