Provider Demographics
NPI:1497553978
Name:CACHE VALLEY MIDWIFERY GROUP LLC
Entity type:Organization
Organization Name:CACHE VALLEY MIDWIFERY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMESON
Authorized Official - Middle Name:
Authorized Official - Last Name:HEPNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-232-3286
Mailing Address - Street 1:2885 S 5900 W
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:UT
Mailing Address - Zip Code:84325-9789
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2380 N 400 E STE D
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-1756
Practice Address - Country:US
Practice Address - Phone:435-770-5627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing