Healthcare Provider Details

I. General information

NPI: 1114479417
Provider Name (Legal Business Name): PAIGE YOLANDA ST. CYR CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2016
Last Update Date: 11/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ELA ST
DOVER NH
03820-3107
US

IV. Provider business mailing address

1 ELA ST
DOVER NH
03820-3107
US

V. Phone/Fax

Practice location:
  • Phone: 603-387-0036
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: