Doctor Name: | KIRSTEN HAROLDSON |
NPI Number: | 1316332836 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 4704251552 |
Business Practice Address: | 45450 24th St Mattawan, MI - 490718769 |
Business Phone Number: | 2697442023 |
Business Fax Number: | |
Mailing Address: | 45450 24th St, MATTAWAN |
State: | MI |
Postal Code: | 490718769 |
Phone Number: | 2697442023 |
Fax Number: | |
NPI Enumeration Date: | 04/01/2015 |
NPI Last Update Date: | 04/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WL0100X |
License Number: | 4704251552 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Lactation Consultant |
Taxonomy Definition: |