Kalu Jane Vaughan, CPM, CDEM
Individual provider Active NPI Midwife · Fortville, IN
NPI 1497577233 · NPPES record last updated Oct 31, 2024
Key facts
- NPI
- 1497577233
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Midwife 176B00000X
- License
- 90000023A (IN)
- Practice address
- 412 S Maple St
Fortville, IN 46040-1679 - Phone
- (317) 340-3583
- NPI assigned
- Oct 31, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90000023A | IN | MD | Midwife |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 90000023A | IN | Yes |
Addresses
Primary practice location
412 S Maple St
Fortville, IN 46040-1679
Mailing address
412 S Maple St
Fortville, IN 46040-1679
Phone (317) 340-3583
Other providers in Fortville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.