Provider Demographics
NPI:1558673897
Name:WOMAN'S WAY HOMEBIRTH SERVICES
Entity Type:Organization
Organization Name:WOMAN'S WAY HOMEBIRTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED DIRECT-ENTRY MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:STIERS
Authorized Official - Suffix:
Authorized Official - Credentials:CDM, CPM
Authorized Official - Phone:907-262-9446
Mailing Address - Street 1:154 W MARYDALE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7501
Mailing Address - Country:US
Mailing Address - Phone:907-262-9446
Mailing Address - Fax:907-262-9354
Practice Address - Street 1:154 W MARYDALE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7501
Practice Address - Country:US
Practice Address - Phone:907-262-9446
Practice Address - Fax:907-262-9354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK56175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175M00000XOther Service ProvidersMidwife, LayGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNM 9580Medicaid