Creekside Birth Cottage
Organization Active NPI Midwife · Payson, AZ
NPI 1679350698 · NPPES record last updated Sep 12, 2023
Key facts
- NPI
- 1679350698
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Midwife 176B00000X
- Legal business name
- CREEKSIDE BIRTH COTTAGE
- Practice address
- 215 W Frontier St
Payson, AZ 85541-5318 - Phone
- (928) 951-6410
- NPI assigned
- Sep 12, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- CREEKSIDE MIDWIFERY LLC
Authorized official
- Name
- Lacey Tackett
- Title
- Member
- Phone
- (928) 951-6410
Practitioners 1
National Provider Directory
- Part of
- Creekside Birth Cottage
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife |
176B00000X | Yes |
Addresses
Primary practice location
215 W Frontier St
Payson, AZ 85541-5318
Mailing address
215 W Frontier St
Payson, AZ 85541-5318
Other providers in Payson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.