Organization
COASTAL FAMILY BIRTH RETREAT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE ANN JACQUES RN, CPM, NHCM (OWNER, ADMINISTRATOR)
(603) 580-2327
Entity
Organization
Contact information
Practice address
13 FRYING PAN LN, STRATHAM, NH 03885-2506
(603) 580-2327
(603) 580-2326
Mailing address
13 FRYING PAN LN, STRATHAM, NH 03885-2506
(603) 580-2327
(603) 580-2326
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary
1009
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30462658
—
NH
05
—
30464876
—
NH
Enumeration date
03/16/2007
Last updated
08/22/2020
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