Healthcare Provider Details

I. General information

NPI: 1558673897
Provider Name (Legal Business Name): WOMAN'S WAY HOMEBIRTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 11/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 W MARYDALE AVE SUITE B
SOLDOTNA AK
99669-7501
US

IV. Provider business mailing address

154 W MARYDALE AVE SUITE B
SOLDOTNA AK
99669-7501
US

V. Phone/Fax

Practice location:
  • Phone: 907-262-9446
  • Fax: 907-262-9354
Mailing address:
  • Phone: 907-262-9446
  • Fax: 907-262-9354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number56
License Number StateAK

VIII. Authorized Official

Name: ANDREA STIERS
Title or Position: CERTIFIED DIRECT-ENTRY MIDWIFE
Credential: CDM, CPM
Phone: 907-262-9446