Provider Demographics
NPI:1720484793
Name:RED TENT BIRTHING SERVICES
Entity type:Organization
Organization Name:RED TENT BIRTHING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CPM/CERTIFIED PROFESSIONAL MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:TONESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-741-3678
Mailing Address - Street 1:28830 KNOB HILL CT
Mailing Address - Street 2:
Mailing Address - City:ROCK FALLS
Mailing Address - State:IL
Mailing Address - Zip Code:61071-9498
Mailing Address - Country:US
Mailing Address - Phone:815-716-1543
Mailing Address - Fax:
Practice Address - Street 1:1134 BIGGER ST
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46404-1838
Practice Address - Country:US
Practice Address - Phone:219-741-3678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty