Mnmidwife

NPI #1326301532 in Ham Lake, Minnesota

Provider Information

NPI Number: 1326301532
Entity Type: Organization
Organization Name: Mnmidwife
Primary Specialty: Midwife
Enumeration Date: Jun 21, 2012
Last Updated: Jun 21, 2012

Practice Location

Address: 16930 CHISHOLM ST NE
City: Ham Lake
State: Minnesota
ZIP Code: 55304-4923
Phone: (651) 329-4514

Authorized Official

Name: MS. PAMELA JO ANNE BERGERON, TM
Title: MIDWIFE
Phone: (651) 329-4514

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Midwife	176B00000X	Primary

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