Jackie Donceel Squires CNM

NPI 1386740215 - Advanced Practice Midwife - 367A00000X

NPI Details
NPI 1386740215
Gender Female
Enumeration Date 09/16/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
338 S WALNUT ST
BLOOMINGTON IN, 47401-3500, US
Phone (812) 349-7343
Fax (812) 349-7346
Business Location
9501 W WOLF MOUNTAIN RD
GOSPORT IN, 47433-9597, US
Phone (812) 876-4151
Fax
Toxanomy
Taxonomy Code 367A00000X
License State Indiana
License Number 72000030
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According to our database, Mrs. Jackie Donceel Squires CNM NPI is 1386740215, taxonomy code is 367A00000X and license number is 72000030, license state is located at Indiana. Jackie Donceel Squires CNM physically located at 338 S Walnut St, Bloomington IN, 47401-3500. NPI Number Jackie Donceel Squires CNM has the Individual type.

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1386740215 NPI number is provided on an as is basis without warranty of any kind. 1386740215 is maintained by the National Plan & Provider Enumeration System. The contents of Jackie Donceel Squires CNM are for informational purposes only.