Healthcare Provider Details
I. General information
NPI: 1528656881
Provider Name (Legal Business Name): APPLE TREE MIDWIFERY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/04/2021
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6015 MOUNT RUSHMORE RD STE 2
RAPID CITY SD
57701-8962
US
IV. Provider business mailing address
6015 MOUNT RUSHMORE RD STE 2
RAPID CITY SD
57701-8962
US
V. Phone/Fax
- Phone: 605-858-1269
- Fax:
- Phone: 605-858-1269
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QB0400X |
| Taxonomy | Birthing 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:
CASSIE
APPLEGATE
Title or Position: CNM/OWNER
Credential: CNM
Phone: 605-858-1269