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General NPI Number Information
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NPI Number | 1932556552
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Entity Type | Organization
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Legal Business Name | MIDWIVES CARE
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 2930 MCKINLEY AVE
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City | SOUTH BEND
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State | IN
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Zip | 46615-2739
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Country | US
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Telephone | 574-400-2558
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Fax | 574-400-2557
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Provider Business Mailing Address
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Address Line | 2930 MCKINLEY AVE
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City | SOUTH BEND
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State | IN
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Zip | 46615-2739
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Country | US
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Telephone | 574-400-2558
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Fax | 574-400-2557
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Authorized Official
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Title or Position | OWNER
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Name | KRISTIN LYNN VINCENT
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Credential | CNM
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Telephone | 574-400-2558
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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 | 72000084A
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License Number State | IN
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