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General NPI Number Information
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NPI Number | 1730396516
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Entity Type | Individual
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Provider Name | JUDITH BROCK CNM
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Gender | Female
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 30 LOCUST ST. COOLEY DICKINSON CENTER FOR MIDWIFERY CARE
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City | NORTHAMPTON
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State | MA
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Zip | 01061
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Country | US
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Telephone | 413-584-8953
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Fax | 413-584-1093
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Provider Business Mailing Address
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Address Line | 688 COACHING LN
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City | BROWNSVILLE
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State | VT
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Zip | 05037-4400
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Country | US
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Telephone | 802-484-5187
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 154535
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License Number State | MA
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