Healthcare Provider Details

I. General information

NPI: 1346560877
Provider Name (Legal Business Name): NEW LIFE MIDWIFERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 06/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 E SWANSON AVE SUITE 26
WASILLA AK
99654-7056
US

IV. Provider business mailing address

PO BOX 4263
PALMER AK
99645-4263
US

V. Phone/Fax

Practice location:
  • Phone: 907-232-1664
  • Fax: 907-373-3672
Mailing address:
  • Phone: 907-745-4766
  • Fax: 907-745-4766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberAA32
License Number StateAK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierNM44021
Identifier TypeMEDICAID
Identifier StateAK
Identifier Issuer
# 2
IdentifierNM0007
Identifier TypeMEDICAID
Identifier StateAK
Identifier Issuer

VIII. Authorized Official

Name: MRS. HOLLY STEINER
Title or Position: OWNER/MIDWIFE
Credential: CDM
Phone: 907-745-4766