MEDICARE: MS. KRISTEN ANN BERNARD MIDWIFE

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
1	175M00000X	Lay Midwife	NOT APPLICABLE

General Provider Information

NPI Number	:	1952583916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTEN ANN BERNARD MIDWIFE

Provider Business Mailing Address
First Line	:	34 MAIN ST
Second Line	:	SUIT 1
City	:	AMHERST
State	:	MA
Zip	:	01002-2356
Country	:	US
Telephone Number	:	413-256-6166
Fax Number	:

Provider Business Practice Location Address
First Line	:	34 MAIN ST
Second Line	:	SUIT 1
City	:	AMHERST
State	:	MA
Zip	:	01002-2356
Country	:	US
Telephone Number	:	413-256-6166
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2007
Last Update Date	:	12/03/2007

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