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General NPI Number Information
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NPI Number | 1851039903
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Entity Type | Individual
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Provider Name | JODI CASPER CNM
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Gender | Female
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Dates
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Enumeration Date | 05/26/2022
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Last Update Date | 05/26/2022
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Provider Practice Location Address
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Address Line | BELLA VITA HEALTHCARE 18 E BEECH ST
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City | COTTONWOOD
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State | AZ
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Zip | 86326
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Country | US
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Telephone | 928-634-0391
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Fax |
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Provider Business Mailing Address
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Address Line | 2250 S FERN ST
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City | WASILLA
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State | AK
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Zip | 99654-8560
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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 |
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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 | 258856
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License Number State | AZ
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