Provider Demographics
NPI:1922315597
Name:WINDSONG MIDWIFERY, LLC
Entity Type:Organization
Organization Name:WINDSONG MIDWIFERY, LLC
Other - Org Name:THE BIRTH PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:CDM
Authorized Official - Phone:907-373-2672
Mailing Address - Street 1:PO BOX 874553
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-4553
Mailing Address - Country:US
Mailing Address - Phone:907-373-2672
Mailing Address - Fax:907-373-5417
Practice Address - Street 1:5805 E COLUMBUS WAY
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7831
Practice Address - Country:US
Practice Address - Phone:907-373-2672
Practice Address - Fax:907-373-5417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK31176B00000X
AKFBC-004261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMPG0288Medicaid