Individual
KRISTIN MARIE MORTENSEN-WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LM CPM, LCPM
Contact information
Practice address
14100 KENNEDY RD, FULTON, IL 61252-9619
(309) 507-2420
Mailing address
14100 KENNEDY RD, FULTON, IL 61252-9619
(309) 507-2420
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
—
—
176B00000X
Midwife
Primary
295.000022
IL
176B00000X
Midwife
528-49
WI
176B00000X
Midwife
CPM0003
IL
Other
Enumeration date
09/29/2022
Last updated
02/24/2025
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