Provider Demographics
NPI:1073298931
Name:BOULDER BIRTH & HOLISTIC HEALTH
Entity Type:Organization
Organization Name:BOULDER BIRTH & HOLISTIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ABRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUPAL
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:970-903-1802
Mailing Address - Street 1:2800 FOLSOM ST STE C
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3768
Mailing Address - Country:US
Mailing Address - Phone:303-443-3993
Mailing Address - Fax:
Practice Address - Street 1:2800 FOLSOM ST STE C
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3768
Practice Address - Country:US
Practice Address - Phone:303-443-3993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthingGroup - Multi-Specialty
No363LP1700XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPerinatalGroup - Multi-Specialty
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's HealthGroup - Multi-Specialty