Individual
KATHERINE BULTHUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1775 W DEMPSTER ST, PARK RIDGE, IL 60068-1143
(847) 723-5237
Mailing address
1775 W DEMPSTER ST, PARK RIDGE, IL 60068-1143
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
041359251
IL
364SN0000X
Neonatal Clinical Nurse Specialist
Primary
209012899
IL
Other
Enumeration date
12/07/2018
Last updated
12/07/2018
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