Miranda Nicole Wentlandt, MSM, LM, CPM

Primary specialty

MidwifeTaxonomy code 176B00000X

Practice address

20696 Bond Road NE
BLDG C, Suite 110
Poulsbo, WA 98370-9025

Phone

(360) 779-0004

Fax

(360) 938-8791

NPI assigned

Nov 19, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Miranda Nicole Rasmusson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1265199624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 MADRONA DR NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983355927",
            "telephone_number": "425-495-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20696 BOND ROAD NE",
            "address_2": "BLDG C, SUITE 110",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709025",
            "telephone_number": "360-779-0004",
            "fax_number": "360-938-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTLANDT",
        "first_name": "MIRANDA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MSM, LM, CPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-19",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "RASMUSSON",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Midwife in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Midwife in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.