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General NPI Number Information
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NPI Number | 1679228837
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Entity Type | Organization
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Legal Business Name | PRISM MIDWIFERY LLC
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 02/16/2022
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Provider Practice Location Address
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Address Line | 3845 N DOUGLAS HWY
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City | JUNEAU
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State | AK
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Zip | 99801-6468
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Country | US
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Telephone | 907-723-5775
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Fax | 505-393-4513
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Provider Business Mailing Address
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Address Line | 3845 N DOUGLAS HWY
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City | JUNEAU
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State | AK
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Zip | 99801-6468
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Country | US
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Telephone | 907-723-5775
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Fax | 505-393-4513
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Authorized Official
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Title or Position | MIDWIFE
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Name | MS. JOHANNA CROSSETT
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Credential | CDM
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Telephone | 907-723-5775
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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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