Healthcare Provider Details

I. General information

NPI: 1295321552
Provider Name (Legal Business Name): MOUNTAIN HOME BIRTH & MIDWIFERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4055 AL HIGHWAY 9 STE E
CEDAR BLUFF AL
35959-5173
US

IV. Provider business mailing address

PO BOX 322
CEDAR BLUFF AL
35959-0322
US

V. Phone/Fax

Practice location:
  • Phone: 770-421-5927
  • Fax: 706-984-5395
Mailing address:
  • Phone: 770-421-5927
  • Fax: 706-984-5395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. BEVERLY MARIA CRANFORD
Title or Position: OWNER
Credential: CPM MSM
Phone: 770-421-5927