Provider Demographics
NPI:1497717052
Name:KILLEBREW, CLAUDIA (CNM)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:KILLEBREW
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 1:1248 E 90 N
Mailing Address - Street 2:STE 300
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2956
Mailing Address - Country:US
Mailing Address - Phone:801-756-1577
Mailing Address - Fax:801-216-8357
Practice Address - Street 1:1248 E 90 N
Practice Address - Street 2:STE 300
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2956
Practice Address - Country:US
Practice Address - Phone:801-756-1577
Practice Address - Fax:801-216-8357
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT215423-4402176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD0549Medicaid
UT005527701Medicare ID - Type Unspecified
UTD0549Medicaid