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NPI Code Detail

MEDICARE: MRS. KATHLEEN GREENHALGH CNM

MEDICARE: MRS. KATHLEEN GREENHALGH 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
1363LW0102XWomen's Health Nurse Practitioner25ME00035001NJ

General Provider Information

NPI Number : 1083600068
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHLEEN GREENHALGH CNM
Provider Business Mailing Address
First Line : 690 BARNES BLVD
Second Line :
City : JOINT BASE LEWIS MCCHORD
State : WA
Zip : 98438-1103
Country : US
Telephone Number : 253-982-0276
Fax Number :
Provider Business Practice Location Address
First Line : 690 BARNES BLVD
Second Line :
City : JOINT BASE LEWIS MCCHORD
State : WA
Zip : 98438-1303
Country : US
Telephone Number : 253-982-0276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 03/22/2013

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