Individual
KATHLEEN A BREAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.N.M.
Contact information
Practice address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-3909
(607) 547-6325
Mailing address
2109 FIFTEENTH STREET, CAPITAL REGION MIDWIFERY, TROY, NY 12180
(518) 326-1620
(518) 326-1622
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
F000561
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01780170
—
NY
Enumeration date
05/17/2006
Last updated
09/13/2012
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