# HEIRLOOM WELLNESS & BIRTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heirloom Birth Center, LLC, Heritage Health and Birth LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457659906
- **Authorized official:** KIRSTEN A GERRISH CDM (OWNER/MANAGER)
- **Authorized official phone:** (907) 746-6644

## Contact information

- **Practice address:** 2323 S TRUNK RD, SUITE 6, PALMER, AK 99645
- **Practice address phone:** (907) 746-6644
- **Practice address fax:** (317) 667-1982
- **Mailing address:** 2323 S TRUNK RD, SUITE 6, PALMER, AK 99645
- **Mailing address phone:** (907) 746-6644
- **Mailing address fax:** (317) 667-1982

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 176B00000X | Midwife | — | NULL | — |
| 176B00000X | Midwife | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QB0400X | Birthing Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/08/2011
- **Last updated:** 11/16/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1571890 | — | AK |
| 05 | — | 1657481 | — | AK |