NPI 1104470079

Kathryn Michele Blackport, MSNCNM

Practitioner Advanced Practice Midwife Royal Oak, MI

Practice location

Address: 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712
Phone: (248) 898-4021
Mailing address: 3915 Elmhurst Ave, Royal Oak, MI 48073-1862

Registered specialties (2)

Advanced Practice Midwife Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367A00000X Licence 4704307657 (MI)

Other Advanced Practice Midwife providers in Michigan →

Midwife

Other Service Providers Taxonomy 176B00000X Licence 470407657 (MI)

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Registry record

NPI: 1104470079
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Jul 2019
Record last updated: 19 Jul 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.