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General NPI Number Information
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NPI Number | 1235468505
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Entity Type | Organization
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Legal Business Name | ARCTIC MIDWIVES, LLC
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Dates
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Enumeration Date | 12/16/2009
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Last Update Date | 12/16/2009
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Provider Practice Location Address
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Address Line | 728 GAFFNEY RD STE 100
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City | FAIRBANKS
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State | AK
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Zip | 99701-4658
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Country | US
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Telephone | 907-456-3719
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Fax | 907-456-1511
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Provider Business Mailing Address
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Address Line | 728 GAFFNEY RD STE 100
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City | FAIRBANKS
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State | AK
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Zip | 99701-4658
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Country | US
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Telephone | 907-456-3719
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Fax | 907-456-1511
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Authorized Official
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Title or Position | MIDWIFE
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Name | VANESSA DUNHAM
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Credential | CDM, CPM
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Telephone | 907-456-3719
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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 | 913507
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License Number State | AK
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