=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407748940
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BIRTHSTONE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2025
-----------------------------------------------------
Last Update Date | 07/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 342 MONMOUTH AVE S
-----------------------------------------------------
City | MONMOUTH
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97361-2110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-602-3084
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 342 MONMOUTH AVE S
-----------------------------------------------------
City | MONMOUTH
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97361-2110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-602-3084
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MIDWIFE- OWNER
-----------------------------------------------------
Name | NICOLETTE ROSE NOE
-----------------------------------------------------
Credential | APRN-CNM
-----------------------------------------------------
Telephone | 541-602-3084
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------