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General NPI Number Information
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NPI Number | 1427347566
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Entity Type | Organization
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Legal Business Name | FAMILY & WOMEN'S HEALTH SERVICES
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Dates
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Enumeration Date | 03/29/2011
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Last Update Date | 03/29/2011
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Provider Practice Location Address
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Address Line | 2418 CURTIS DR STE A
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City | WINAMAC
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State | IN
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Zip | 46996-8818
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Country | US
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Telephone | 574-946-3835
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Fax | 574-946-4710
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Provider Business Mailing Address
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Address Line | 2418 CURTIS DR STE A
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City | WINAMAC
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State | IN
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Zip | 46996-8818
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Country | US
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Telephone | 574-946-3835
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Fax | 574-946-4710
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Authorized Official
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Title or Position | PRESIDENT
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Name | CLINTON KAUFFMAN
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Credential | MD
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Telephone | 574-946-3835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 71000039A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01057944A
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License Number State | IN
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