Individual
KRISTEN ANNE PETHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM
Contact information
Practice address
1230 W COLLEGE AVE STE C, APPLETON, WI 54914-5287
(920) 574-3074
(920) 574-9502
Mailing address
W2774 E JEFFERSON RD, CHILTON, WI 53014-9670
(608) 206-1493
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
—
Other
Enumeration date
07/05/2022
Last updated
07/05/2022
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