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General NPI Number Information
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NPI Number | 1194251843
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Entity Type | Organization
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Legal Business Name | ROSEBUD BIRTHING SERVICES
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Dates
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Enumeration Date | 05/02/2017
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Last Update Date | 05/02/2017
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Provider Practice Location Address
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Address Line | 2130 ACADEMY CIR STE D
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1675
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Country | US
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Telephone | 719-641-2543
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Fax |
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Provider Business Mailing Address
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Address Line | 12624 PINE VALLEY CIR
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City | FALCON
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State | CO
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Zip | 80831-4019
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Country | US
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Telephone | 719-641-2543
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Fax |
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Authorized Official
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Title or Position | OWNER/MIDWIFE
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Name | STEPHANIE LEIGH SIBERT
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Credential | C.P.M., R.M.
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Telephone | 719-641-2543
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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 | MWR.0000175
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License Number State | CO
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