Healthcare Provider Details

I. General information

NPI: 1912827056
Provider Name (Legal Business Name): AMY HELENE FREY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 160184
BIG SKY MT
59716-0184
US

IV. Provider business mailing address

57 JUNIPER BERRY DR # 160184
BIG SKY MT
59716-7844
US

V. Phone/Fax

Practice location:
  • Phone: 916-317-8846
  • Fax:
Mailing address:
  • Phone: 916-317-8846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number236631
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: