Individual
MS. TIANA J. LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
57 WATER ST, BLUE HILL, ME 04614-5231
(207) 374-3940
(207) 374-3980
Mailing address
57 WATER ST, BLUE HILL, ME 04614-5231
(207) 374-3940
(207) 374-3980
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
001490
NY
176B00000X
Midwife
Primary
CNM142001
ME
367A00000X
Advanced Practice Midwife
AP60401092
WA
Other
Enumeration date
07/20/2012
Last updated
06/04/2014
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