Provider Demographics
NPI:1639787815
Name:FAMILY MIDWIFERY, LLC
Entity Type:Organization
Organization Name:FAMILY MIDWIFERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GENGI
Authorized Official - Middle Name:GUNN
Authorized Official - Last Name:PROTEAU
Authorized Official - Suffix:
Authorized Official - Credentials:CPM
Authorized Official - Phone:860-227-0173
Mailing Address - Street 1:23 ROSEMONT DRIVE
Mailing Address - Street 2:
Mailing Address - City:DEEP RIVIER
Mailing Address - State:CT
Mailing Address - Zip Code:06417
Mailing Address - Country:US
Mailing Address - Phone:860-227-0173
Mailing Address - Fax:877-592-5962
Practice Address - Street 1:23 ROSEMONT DRIVE
Practice Address - Street 2:
Practice Address - City:DEEP RIVIER
Practice Address - State:CT
Practice Address - Zip Code:06417
Practice Address - Country:US
Practice Address - Phone:860-227-0173
Practice Address - Fax:877-592-5962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty