Provider Demographics
NPI:1265768790
Name:BIRTHWAYS MIDWIFERY, LLC
Entity type:Organization
Organization Name:BIRTHWAYS MIDWIFERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CDM
Authorized Official - Phone:907-349-3054
Mailing Address - Street 1:1108 E NORTHERN LIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4219
Mailing Address - Country:US
Mailing Address - Phone:907-349-3054
Mailing Address - Fax:907-349-3056
Practice Address - Street 1:1108 E NORTHERN LIGHTS BLVD STE C
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4259
Practice Address - Country:US
Practice Address - Phone:907-349-3054
Practice Address - Fax:907-349-3056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-17
Last Update Date:2009-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNM0006176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNM0006Medicaid
AKNM0055Medicaid