Organization
BLUE MOON MIDWIFERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA ELENA KIRKWOOD WEAVER CPM (OWNER)
(715) 308-9540
Entity
Organization
Contact information
Practice address
113 WHEELOCK PKWY E, SAINT PAUL, MN 55117-3934
(715) 308-9540
Mailing address
113 WHEELOCK PKWY E, SAINT PAUL, MN 55117-3934
(715) 308-9540
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
—
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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