Healthcare Provider Details

I. General information

NPI: 1548572886
Provider Name (Legal Business Name): BIRTH CIRCLE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 N WALLACE AVE SUITE C
BOZEMAN MT
59715-3024
US

IV. Provider business mailing address

820 N WALLACE AVE SUITE C
BOZEMAN MT
59715-3024
US

V. Phone/Fax

Practice location:
  • Phone: 406-581-2073
  • Fax: 888-858-2409
Mailing address:
  • Phone: 406-581-2073
  • Fax: 888-858-2409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. STACEY HAUGLAND
Title or Position: OWNER
Credential: CPM
Phone: 406-581-2073