Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLY DIETZEN, LM
Active Sole ProprietorKELLY DIETZEN, LM is a Midwife healthcare provider located in GLENDALE, California. NPI 1760787121 is currently active in the NPPES registry. Verify at CMS.
Midwife · GLENDALE, CA
Registration Details
- NPI Number
- 1760787121
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 17, 2011 (15.530569312185 yrs)
- Last Updated
- Jan 17, 2011
- License
-
257 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1327 CAMPBELL STGLENDALE, CA, 912071446Browse CA providers · Browse ZIP 91207
- Phone
- 3232404024
- Primary Specialty
-
Midwife
176B00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.