Individual
MRS. KATHLEEN LAURA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1200
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
111967
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37203371
—
CO
Enumeration date
06/13/2006
Last updated
10/29/2015
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