Individual
KATHLEEN A LAVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
500 S JACKSON ST, JACKSON, MI 49203-1709
(517) 796-1398
(517) 796-8057
Mailing address
500 S JACKSON ST, JACKSON, MI 49203-1709
(517) 796-1398
(517) 796-8057
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
KL183182
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4563623
—
MI
05
—
4790069
—
MI
Enumeration date
08/23/2005
Last updated
12/18/2012
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