Individual
KATHRYN LORRAINE KOOISTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
930 3RD ST, GREENSBORO, NC 27405-6967
(336) 890-3200
(336) 890-3290
Mailing address
104 JASMINE CT, CARRBORO, NC 27510-4119
(404) 909-1228
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
CNM653
NC
Other
Enumeration date
08/06/2017
Last updated
03/02/2023
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