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Individual

JERI S. KITCHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5381
(740) 446-5082
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5381
(740) 446-5082

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
156
WV
367A00000X
Advanced Practice Midwife
Primary
APRN.CNM.10281
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000258858
OHIO MEDICAID UNISON
OH
01
2875376
OHIO MEDICAID MOLINA
OH
05
2875376
OH
01
310917085200
OHIO MEDICAID CARESOURCE
OH
05
3810013407
WV
01
KINM03651
MEDICARE
01
P00725268
RAILROAD MEDICARE
Enumeration date
10/01/2008
Last updated
10/29/2019
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