Healthcare Provider Details

I. General information

NPI: 1871425785
Provider Name (Legal Business Name): HARMONY HEALTH & HOME BIRTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 W STATE ST
O FALLON IL
62269-1913
US

IV. Provider business mailing address

502 W STATE ST
O FALLON IL
62269-1913
US

V. Phone/Fax

Practice location:
  • Phone: 618-417-7148
  • Fax: 904-615-8373
Mailing address:
  • Phone: 618-417-7148
  • Fax: 904-615-8373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: KACEY A PANYIK
Title or Position: CNM
Credential: CNM
Phone: 618-417-7148