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General NPI Number Information
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NPI Number | 1649772203
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Entity Type | Organization
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Legal Business Name | WABASH VALLEY MIDWIVES
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Dates
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Enumeration Date | 02/28/2018
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Last Update Date | 02/28/2018
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Provider Practice Location Address
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Address Line | 1176 N COUNTY ROAD 300 W
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City | BRAZIL
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State | IN
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Zip | 47834-7499
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Country | US
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Telephone | 812-531-0681
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Fax |
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Provider Business Mailing Address
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Address Line | 1176 N COUNTY ROAD 300 W
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City | BRAZIL
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State | IN
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Zip | 47834-7499
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CERTIFIED PROFESSIONAL MIDWIFE
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Name | MRS. SAMANTHA E BRINKERHOFF
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Credential | CPM
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Telephone | 217-712-6303
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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 | IN
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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