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General NPI Number Information
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NPI Number | 1477641777
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Entity Type | Individual
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Provider Name | KATHY G MCCLISH CNM
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 01/05/2018
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Provider Practice Location Address
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Address Line | 4357 FERGUSON DR STE. 210
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City | CINCINNATI
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State | OH
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Zip | 45245-1689
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Country | US
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Telephone | 513-732-0100
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Fax | 513-732-9006
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Provider Business Mailing Address
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Address Line | 4685 FOREST AVE STE C
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City | CINCINNATI
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State | OH
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Zip | 45212-3359
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Country | US
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Telephone | 513-891-2813
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Fax | 513-793-1032
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | NM-06637
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License Number State | OH
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