Healthcare Provider Details

I. General information

NPI: 1720245285
Provider Name (Legal Business Name): EVERYDAY BLESSINGS MIDWIFERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S JACKSON ST
JACKSON MI
49203-1709
US

IV. Provider business mailing address

500 S JACKSON ST
JACKSON MI
49203-1709
US

V. Phone/Fax

Practice location:
  • Phone: 517-796-1398
  • Fax: 517-796-8057
Mailing address:
  • Phone: 517-796-1398
  • Fax: 517-796-8057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number4704183182
License Number StateMI

VIII. Authorized Official

Name: MS. KATHLEEN A V LAVERY
Title or Position: OWNER
Credential: CNM
Phone: 517-796-1398