Provider Demographics
NPI:1467026955
Name:ECKSTROM, KAYLEIGH E (CNM)
Entity Type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:E
Last Name:ECKSTROM
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 COLLINS CORNER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1300
Mailing Address - Country:US
Mailing Address - Phone:540-850-7797
Mailing Address - Fax:
Practice Address - Street 1:238 COLLINS CORNER RD
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1300
Practice Address - Country:US
Practice Address - Phone:540-850-7797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife