Organization
WAREHAM NURSE MIDWIVES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUISE RACINE BASTARACHE CNM MS NP (PRESIDENT)
(508) 295-3088
Entity
Organization
Contact information
Practice address
332 MAIN STREET, WAREHAM, MA 02571
(508) 295-3088
(508) 295-2079
Mailing address
332 MAIN STREET, WAREHAM, MA 02571
(508) 295-3088
(508) 295-2079
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
143429
MA
363L00000X
Nurse Practitioner
143429
MA
367A00000X
Advanced Practice Midwife
275550
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9783571
—
MA
01
—
NC0012
BCBS
MA
Enumeration date
11/16/2007
Last updated
08/03/2010
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