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Individual

KATHRYN GRETCHEN DIRKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
4625 LINDELL BLVD FL 2, SAINT LOUIS, MO 63108-3739
(914) 919-9200
Mailing address
458 PARK AVE SE, ATLANTA, GA 30312-3452
(440) 935-5719

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
CNM04860
GA
176B00000X
Midwife
Primary
RN261804
GA
363LF0000X
Family Nurse Practitioner
RN261804
GA

Other

Enumeration date
06/07/2018
Last updated
06/12/2024
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