Healthcare Provider Details

I. General information

NPI: 1659899102
Provider Name (Legal Business Name): AVEREE CHIFAMBA CD(DONA), CPM, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2017
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 SWIFTWATER DR
BOZEMAN MT
59715
US

IV. Provider business mailing address

38 SWIFTWATER DR
BOZEMAN MT
59715-8761
US

V. Phone/Fax

Practice location:
  • Phone: 406-599-3153
  • Fax:
Mailing address:
  • Phone: 406-599-3153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberAHC-MID-LIC-2337
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberAHC-MID-LIC-2337
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number11661
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: