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Individual
KATHLEEN MARK
Active
Individual
KATHLEEN MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
1924744402
UT
367A00000X
Advanced Practice Midwife
192474-4402
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160009437
MEDICARE RAILROAD
UT
05
—
D0895
—
UT
Enumeration date
07/25/2006
Last updated
08/13/2009
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