Healthcare Provider Details

I. General information

NPI: 1063981819
Provider Name (Legal Business Name): MIDWIVES OF CONCORD BIRTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2018
Last Update Date: 11/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 N STATE ST UNIT D
CONCORD NH
03301-3224
US

IV. Provider business mailing address

254 N STATE ST UNIT D
CONCORD NH
03301-3224
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-8710
  • Fax: 603-228-8711
Mailing address:
  • Phone: 603-228-8710
  • Fax: 603-228-8711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHRYN HARTWELL
Title or Position: OWNER
Credential: NHCM, CPM
Phone: 603-228-8710