Provider Demographics
NPI:1194392712
Name:KALISPELL MIDWIVES & WOMENS HEALTH INC
Entity Type:Organization
Organization Name:KALISPELL MIDWIVES & WOMENS HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNM
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUND
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:406-212-0214
Mailing Address - Street 1:165 COMMONS LOOP STE A
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1919
Mailing Address - Country:US
Mailing Address - Phone:406-461-9635
Mailing Address - Fax:
Practice Address - Street 1:165 COMMONS LOOP STE A
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1919
Practice Address - Country:US
Practice Address - Phone:406-212-0214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty