Provider Demographics
NPI:1154795193
Name:GENTLE BEGINNINGS MIDWIFE
Entity type:Organization
Organization Name:GENTLE BEGINNINGS MIDWIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDUNN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNM
Authorized Official - Phone:406-799-4545
Mailing Address - Street 1:2300 12TH AVE S
Mailing Address - Street 2:SUITE 128
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5017
Mailing Address - Country:US
Mailing Address - Phone:406-799-4545
Mailing Address - Fax:406-452-1742
Practice Address - Street 1:2300 12TH AVE S
Practice Address - Street 2:SUITE 128
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5017
Practice Address - Country:US
Practice Address - Phone:406-799-4545
Practice Address - Fax:406-452-1742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN24552367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT7173621Medicaid