Provider Demographics
NPI:1720245285
Name:EVERYDAY BLESSINGS MIDWIFERY PLLC
Entity Type:Organization
Organization Name:EVERYDAY BLESSINGS MIDWIFERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:A V
Authorized Official - Last Name:LAVERY
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:517-796-1398
Mailing Address - Street 1:500 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-1709
Mailing Address - Country:US
Mailing Address - Phone:517-796-1398
Mailing Address - Fax:517-796-8057
Practice Address - Street 1:500 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-1709
Practice Address - Country:US
Practice Address - Phone:517-796-1398
Practice Address - Fax:517-796-8057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704183182367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4563623Medicaid
MI4563623Medicaid
MIS06124Medicare UPIN