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General NPI Number Information
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NPI Number | 1467826867
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Entity Type | Organization
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Legal Business Name | FERN CREEK MIDWIVES
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 119 EAST IDAHO STREET
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City | KALISPELL
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State | MT
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Zip | 59901-4012
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Country | US
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Telephone | 406-260-5105
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Fax | 406-758-0283
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Provider Business Mailing Address
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Address Line | 119 EAST IDAHO STREET
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City | KALISPELL
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State | MT
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Zip | 59901-4012
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Country | US
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Telephone | 406-260-5105
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Fax | 406-758-0283
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Authorized Official
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Title or Position | OWNER
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Name | CARRIE ELIZABETH CORBETT
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Credential | LM, CPM
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Telephone | 406-260-5105
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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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