Provider Demographics
NPI:1356056352
Name:406 MIDWIFERY, INC
Entity type:Organization
Organization Name:406 MIDWIFERY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:EVENS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNM, FNP-C
Authorized Official - Phone:406-945-5551
Mailing Address - Street 1:PO BOX 1015
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-1015
Mailing Address - Country:US
Mailing Address - Phone:406-945-5551
Mailing Address - Fax:406-625-2552
Practice Address - Street 1:2404 39TH ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1123
Practice Address - Country:US
Practice Address - Phone:406-945-5551
Practice Address - Fax:405-625-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty