Provider Demographics
NPI:1992154306
Name:IN THE BEGINNING MIDWIFE SERVICE
Entity type:Organization
Organization Name:IN THE BEGINNING MIDWIFE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:CRAWFORD
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:715-445-2277
Mailing Address - Street 1:PO BOX 402
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:WI
Mailing Address - Zip Code:54945-0402
Mailing Address - Country:US
Mailing Address - Phone:715-445-2277
Mailing Address - Fax:866-933-1286
Practice Address - Street 1:308 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:WI
Practice Address - Zip Code:54945
Practice Address - Country:US
Practice Address - Phone:715-445-2277
Practice Address - Fax:866-933-1286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI034-049261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing