Country Midwife Llc
May also be knows as Country Midwife
Legal Business Name
Country Midwife Llc
Also Known As
Country Midwife
NPI Number
1255505525
NPI Type
Organization
Enumeration Date
04/17/2008
Specialties
(Taxonomies)Name
Code
163WW0101X
261QB0400X
163WH0200X
163WL0100X
163WM0102X
176B00000X
163W00000X
Primary Taxonomy
No
No
No
No
No
No
No
Licenses
State
Wisconsin
License Number
31-049
Contact
Information
Purpose
Mailing
Location
Address
1638 DECKNER AVE
1638 DECKNER AVE
City
Green Bay
Green Bay
State
WI
WI
Postal Code
54302-2640
54302-2640
Country
US
US
Telephone Number
(920) 562-9058
(920) 562-9058
Authorized Official
Name
Miss Stacy Vandenput
Title or Position
MIDWIFE, MANAGER
Telephone Number
(920) 562-9058
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 11/05/2010