Individual
CARIE ANN MONDERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1630 LAFAYETTE RD STE 400, CRAWFORDSVILLE, IN 47933-1095
(765) 428-5888
(765) 361-2086
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
71004794A
IN
363LW0102X
Women's Health Nurse Practitioner
71004794A
IN
367A00000X
Advanced Practice Midwife
09000145A
IN
367A00000X
Advanced Practice Midwife
209007251
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201220170
—
IN
01
—
471400417
MEDICARE PTAN
IN
Enumeration date
09/04/2009
Last updated
10/12/2023
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