MEDICARE: LAUREN SIRVAITIS CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	APN.0994181-CNM	CO

General Provider Information

NPI Number	:	1366927105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN SIRVAITIS CNM

Provider Business Mailing Address
First Line	:	109 MODOC PL
Second Line	:
City	:	MANITOU SPRINGS
State	:	CO
Zip	:	80829-2005
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3803 MANCHESTER ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-4828
Country	:	US
Telephone Number	:	719-428-5552
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2018
Last Update Date	:	09/20/2022

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Directions to “ LAUREN SIRVAITIS CNM” Practice Location

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