MEDICARE: KRISTINA MUEHLHAUSER CPM

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
1	176B00000X	Midwife	CPM655	ME

General Provider Information

NPI Number	:	1578193280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA MUEHLHAUSER CPM

Provider Business Mailing Address
First Line	:	7047 LOWER TWIN RD
Second Line	:
City	:	SOUTH SALEM
State	:	OH
Zip	:	45681-9712
Country	:	US
Telephone Number	:	207-385-3986
Fax Number	:	740-634-3006

Provider Business Practice Location Address
First Line	:	7047 LOWER TWIN RD
Second Line	:
City	:	SOUTH SALEM
State	:	OH
Zip	:	45681-9712
Country	:	US
Telephone Number	:	207-385-3986
Fax Number	:	740-634-3006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2020
Last Update Date	:	01/22/2020

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