Provider Demographics
NPI:1043609316
Name:HOLISTIC HOMEBIRTH MADISON, LLC
Entity Type:Organization
Organization Name:HOLISTIC HOMEBIRTH MADISON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:OSER
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, WHNP
Authorized Official - Phone:630-885-6826
Mailing Address - Street 1:52 GOLF COURSE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-1423
Mailing Address - Country:US
Mailing Address - Phone:630-885-6826
Mailing Address - Fax:
Practice Address - Street 1:52 GOLF COURSE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-1423
Practice Address - Country:US
Practice Address - Phone:630-885-6826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI174-49261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service