Healthcare Provider Details

I. General information

NPI: 1093728131
Provider Name (Legal Business Name): PAIGE W HARDY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E FIRST ST
MORRIS MN
56267-0660
US

IV. Provider business mailing address

400 E FIRST ST PO BOX 660
MORRIS MN
56267-0660
US

V. Phone/Fax

Practice location:
  • Phone: 320-589-1313
  • Fax: 320-589-3533
Mailing address:
  • Phone: 320-589-1313
  • Fax: 320-589-3533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberR1258152
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: