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NPI Code Detail

MEDICARE: KALLA CARLTON CNM

MEDICARE:   KALLA  CARLTON  CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife

General Provider Information

NPI Number : 1053840595
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALLA CARLTON CNM
Provider Business Mailing Address
First Line : PO BOX 6730
Second Line :
City : CHANDLER
State : AZ
Zip : 85246-6730
Country : US
Telephone Number : 480-821-3600
Fax Number : 480-857-2667
Provider Business Practice Location Address
First Line : 8410 W THOMAS RD STE 134
Second Line :
City : PHOENIX
State : AZ
Zip : 85037-3374
Country : US
Telephone Number : 623-907-2377
Fax Number : 480-857-2667
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2017
Last Update Date : 06/08/2017

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Directions to “ KALLA CARLTON CNM” Practice Location

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