Provider Demographics
NPI:1750506200
Name:BRUNSCHWYLER, CATHERINE EDITH (CNM)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:EDITH
Last Name:BRUNSCHWYLER
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 1:800 PENNSYLVANIA AVE
Mailing Address - Street 2:WOMENS MEDICINE CENTER
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-3351
Mailing Address - Country:US
Mailing Address - Phone:304-388-2464
Mailing Address - Fax:304-388-2668
Practice Address - Street 1:800 PENNSYLVANIA AVE
Practice Address - Street 2:WOMENS MEDICINE CENTER
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-3351
Practice Address - Country:US
Practice Address - Phone:304-388-2464
Practice Address - Fax:304-388-2668
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV091176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0160123000Medicaid
WV0160123000Medicaid