# BLUE MOON MIDWIVES LLC, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336139757
- **Authorized official:** MS. JANE E MILLS CNM (PARTNER)
- **Authorized official phone:** (207) 739-2800

## Contact information

- **Practice address:** 176 MAIN ST, NORWAY, ME 04268-5643
- **Practice address phone:** (207) 739-2800
- **Practice address fax:** (207) 739-2877
- **Mailing address:** 176 MAIN ST, NORWAY, ME 04268-5643
- **Mailing address phone:** (207) 739-2800
- **Mailing address fax:** (207) 739-2877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 367A00000X | Advanced Practice Midwife | R030353 | ME | Yes |

## Other

- **Enumeration date:** 10/26/2005
- **Last updated:** 08/22/2020