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General NPI Number Information
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NPI Number | 1801698436
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Entity Type | Organization
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Legal Business Name | COMMUNITY BIRTH TWIN CITIES
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 1619 DAYTON AVE STE 316
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City | SAINT PAUL
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State | MN
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Zip | 55104-6276
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Country | US
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Telephone | 612-255-0858
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Fax | 612-446-5776
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Provider Business Mailing Address
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Address Line | 1915 MONTREAL AVE
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City | SAINT PAUL
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State | MN
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Zip | 55116-2010
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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 | OWNER, LICENSED MIDWIFE
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Name | BRITTANY LEE JACKSON
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Credential | CPM, LM
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Telephone | 612-255-0858
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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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