Carly A Detterman CNM

NPI 1538494802 - Advanced Practice Midwife - 367A00000X

NPI Details
NPI 1538494802
Gender Female
Enumeration Date 10/05/2009
Last Updated 05/19/2016
Entity Type Individual
Active Over 7 years ago
Practice Location
3300 MAIN ST
SUITE 4D
SPRINGFIELD MA, 01107-1112, US
Phone (413) 794-8336
Fax (413) 794-5846
Business Location
280 CHESTNUT ST
2ND FLOOR
SPRINGFIELD MA, 01199-1001, US
Phone (413) 794-5700
Fax
Toxanomy
Taxonomy Code 367A00000X
License State Massachusetts
License Number RN256666
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According to our database, Carly A Detterman CNM NPI is 1538494802, taxonomy code is 367A00000X and license number is RN256666, license state is located at Massachusetts. Carly A Detterman CNM physically located at 3300 Main St, Springfield MA, 01107-1112. NPI Number Carly A Detterman CNM has the Individual type.

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1538494802 NPI number is provided on an as is basis without warranty of any kind. 1538494802 is maintained by the National Plan & Provider Enumeration System. The contents of Carly A Detterman CNM are for informational purposes only.