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Individual

MS. ROBERTA RAE POIRIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
640 JACKSON STREET, MC 11503H, ST PAUL, MN 55101-2502
(651) 254-1025
(651) 254-1024
Mailing address
2300 DUNCAN ROAD, BLOOMER, WI 54724
(715) 568-3612

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
1073777
MN
367A00000X
Advanced Practice Midwife
1073777
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
368240400
MN
05
39900600
WI
Enumeration date
06/14/2006
Last updated
05/20/2008
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