Provider Demographics
NPI:1801251665
Name:JUNIPER TREE MIDWIFERY LLC
Entity type:Organization
Organization Name:JUNIPER TREE MIDWIFERY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENCED MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:JUNIPER
Authorized Official - Middle Name:
Authorized Official - Last Name:LANMON-FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPM,CDM
Authorized Official - Phone:907-299-4399
Mailing Address - Street 1:P.O. BOX 811
Mailing Address - Street 2:
Mailing Address - City:KASILOF
Mailing Address - State:AK
Mailing Address - Zip Code:99610-0811
Mailing Address - Country:US
Mailing Address - Phone:907-299-4399
Mailing Address - Fax:907-782-4394
Practice Address - Street 1:26495 VINCENT STREET
Practice Address - Street 2:
Practice Address - City:KASILOF
Practice Address - State:AK
Practice Address - Zip Code:99610-0811
Practice Address - Country:US
Practice Address - Phone:907-299-4399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-22
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1008108261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1518357920OtherINDIVIDUAL NPI #