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General NPI Number Information
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NPI Number | 1649142050
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Entity Type | Organization
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Legal Business Name | GREEN MOUNTAIN BIRTH CENTER, INC
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 903 GOULD HL
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City | JOHNSON
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State | VT
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Zip | 05656-9288
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Country | US
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Telephone | 206-850-3423
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Fax |
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Provider Business Mailing Address
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Address Line | 903 GOULD HL
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City | JOHNSON
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State | VT
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Zip | 05656-9288
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Country | US
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Telephone | 206-850-3423
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Fax |
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Authorized Official
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Title or Position | BOARD OF DIRECTORS
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Name | MARY LOU KOPAS
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Credential | CNM, APRN
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Telephone | 206-850-3423
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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