Healthcare Provider Details

I. General information

NPI: 1326655663
Provider Name (Legal Business Name): ALPINE MIDWIFERY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2020
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 CARSON VW
MARKLEEVILLE CA
96120-9630
US

IV. Provider business mailing address

230 CARSON VIEW
MARKLEEVILLE CA
96120-9630
US

V. Phone/Fax

Practice location:
  • Phone: 530-694-2182
  • Fax: 530-694-1032
Mailing address:
  • Phone: 530-694-2182
  • Fax: 530-694-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LENORA SUE TINSETH
Title or Position: PRESIDENT
Credential: LM, CPM
Phone: 530-694-2182