MEDICARE: GINGER RAELENE KYNION LICENSED MIDWIFE

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	00005	TX

General Provider Information

NPI Number	:	1629292313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINGER RAELENE KYNION LICENSED MIDWIFE

Provider Business Mailing Address
First Line	:	5509 TOPPER CT
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-6475
Country	:	US
Telephone Number	:	817-657-3249
Fax Number	:	817-656-7789

Provider Business Practice Location Address
First Line	:	5509 TOPPER CT
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-6475
Country	:	US
Telephone Number	:	817-657-3249
Fax Number	:	817-656-7789

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

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