Healthcare Provider Details

I. General information

NPI: 1861700940
Provider Name (Legal Business Name): BRIGITTE E. B. EASTMAN CPM, NHCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 HOYT RD
GRAFTON NH
03240-3841
US

IV. Provider business mailing address

31 HOYT RD
GRAFTON NH
03240-3841
US

V. Phone/Fax

Practice location:
  • Phone: 603-523-9525
  • Fax:
Mailing address:
  • Phone: 603-523-9525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number304078-3400
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1037
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: