Healthcare Provider Details

I. General information

NPI: 1386884609
Provider Name (Legal Business Name): GENTLE LANDING MIDWIFERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2009
Last Update Date: 08/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 COLBY ST
BARRE VT
05641-2705
US

IV. Provider business mailing address

174 RIVER ST
MONTPELIER VT
05602-3827
US

V. Phone/Fax

Practice location:
  • Phone: 802-279-3158
  • Fax: 802-448-6880
Mailing address:
  • Phone: 802-279-3158
  • Fax: 802-479-9050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1070000044
License Number StateVT

VIII. Authorized Official

Name: KATHERINE M BRAMHALL
Title or Position: OWNER
Credential: LM
Phone: 802-279-3158