Provider Demographics
NPI:1508420274
Name:BARSTOW, KIMBERLY (CPM)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:BARSTOW
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 WATERMAN RD
Mailing Address - Street 2:
Mailing Address - City:EAST DUMMERSTON
Mailing Address - State:VT
Mailing Address - Zip Code:05346-9784
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:165 WATERMAN RD
Practice Address - Street 2:
Practice Address - City:EAST DUMMERSTON
Practice Address - State:VT
Practice Address - Zip Code:05346-9784
Practice Address - Country:US
Practice Address - Phone:617-710-7811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-27
Last Update Date:2019-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
19020021OtherNORTH AMERICAN REGISTRY OF MIDWIVES
VT107.0129906OtherSTATE OF VERMONT