Healthcare Provider Details

I. General information

NPI: 1982184305
Provider Name (Legal Business Name): ART OF BIRTH MIDWIFERY, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2018
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 CENTRAL ST UNIT 1
RANDOLPH VT
05060-1039
US

IV. Provider business mailing address

17 CENTRAL ST UNIT 1
RANDOLPH VT
05060-1039
US

V. Phone/Fax

Practice location:
  • Phone: 802-431-6030
  • Fax: 802-735-1664
Mailing address:
  • Phone: 802-431-6030
  • Fax: 802-735-1664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number101.0077848
License Number StateVT

VIII. Authorized Official

Name: MEGHAN LOUISE SPERRY
Title or Position: OWNER
Credential: APRN, CNM
Phone: 802-477-3841