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General NPI Number Information
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NPI Number | 1154111862
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Entity Type | Organization
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Legal Business Name | FIRST LIGHT COMMUNITY MIDWIVES, LLC
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 214 HAMMOND ST
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City | BANGOR
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State | ME
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Zip | 04401-4644
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Country | US
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Telephone | 207-262-2035
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Fax |
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Provider Business Mailing Address
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Address Line | 214 HAMMOND ST
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City | BANGOR
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State | ME
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Zip | 04401-4644
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Country | US
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Telephone | 207-262-2035
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINE YENTES
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Credential | CPM
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Telephone | 207-323-2462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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