Provider Demographics
NPI:1124669015
Name:BLOOMINGTON NORMAL BIRTHING CENTER
Entity type:Organization
Organization Name:BLOOMINGTON NORMAL BIRTHING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:BUFFY
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-722-4020
Mailing Address - Street 1:6 WESTPORT CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-8233
Mailing Address - Country:US
Mailing Address - Phone:309-722-4020
Mailing Address - Fax:309-740-4440
Practice Address - Street 1:6 WESTPORT CT
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-8233
Practice Address - Country:US
Practice Address - Phone:309-722-4020
Practice Address - Fax:309-740-4440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty