Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | CNM-170018 | CO |
NPI | 1144504168 |
---|---|
Provider Name | Kala Kluender |
First Address | Boulder, CO 80302-5548 |
Second Address | Boulder, CO 80301-2636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2011 |
Last Update Date | 10/10/2011 |