Individual
KELLIE GWALTNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3400 AVENUE OF THE ARTS, APT. #G317, COSTA MESA, CA 92626-1927
(307) 871-9333
Mailing address
3400 AVENUE OF THE ARTS, APT. #G317, COSTA MESA, CA 92626-1927
(307) 871-9333
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
235651
CA
Other
Enumeration date
12/16/2014
Last updated
12/16/2014
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