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NPI Code Detail

MEDICARE: COMMUNITY MIDWIFERY, LLC

MEDICARE: COMMUNITY MIDWIFERY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1176B00000XMidwifeMWR.0000163CO

General Provider Information

NPI Number : 1932593803
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY MIDWIFERY, LLC
Provider Business Mailing Address
First Line : 2021 W COLORADO AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-3840
Country : US
Telephone Number : 719-761-7541
Fax Number :
Provider Business Practice Location Address
First Line : 2021 W COLORADO AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-3840
Country : US
Telephone Number : 719-761-7541
Fax Number :
Authorized Official
Title or Position : OWNER, MIDWIFE
Name : MAREN J FULLER
Credential : MSM, CPM, RM
Telephone Number : 719-761-7541
Provider Enumeration Date : 03/27/2015
Last Update Date : 03/27/2015

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Directions to “COMMUNITY MIDWIFERY, LLC ” Practice Location

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