Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 001863 | NY |
NPI | 1174015457 |
---|---|
Provider Name | Kristen Marie Klein |
First Address | Schuylerville, NY 12871-1856 |
Second Address | Schuylerville, NY 12871-1856 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2018 |
Last Update Date | 03/06/2018 |