Individual
KATHRYN MICHELE BLACKPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CNM
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-4021
Mailing address
3915 ELMHURST AVE, ROYAL OAK, MI 48073-1862
(586) 604-8350
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
470407657
MI
367A00000X
Advanced Practice Midwife
Primary
4704307657
MI
Other
Enumeration date
07/30/2019
Last updated
07/19/2023
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