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General NPI Number Information
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NPI Number | 1972941185
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Entity Type | Organization
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Legal Business Name | CREATIONS MIDWIFERY, LLC
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Dates
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Enumeration Date | 06/10/2013
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Last Update Date | 08/29/2013
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Provider Practice Location Address
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Address Line | 1235 SAINT PAUL AVENUE
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City | SAINT PAUL
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State | MN
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Zip | 55116
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Country | US
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Telephone | 612-269-1985
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 16577
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City | SAINT PAUL
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State | MN
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Zip | 55116
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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 | DIRECTOR/OWNER/PRESIDENT
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Name | MS. CATHERINE BARBARA MASCARI
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Credential | CNM
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Telephone | 612-269-1985
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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 | R1103100
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License Number State | MN
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