NPI 1386740215

Jackie Donceel Squires, CNM

Practitioner Advanced Practice Midwife Bloomington, IN

Practice location

Address: 338 S Walnut St, Bloomington, IN 47401-3500
Phone: (812) 349-7343
Fax: (812) 349-7346
Mailing address: 9501 W Wolf Mountain Rd, Gosport, IN 47433-9597

Registered specialties

Advanced Practice Midwife Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367A00000X Licence 72000030 (IN)

Other Advanced Practice Midwife providers in Indiana →

Registry record

NPI: 1386740215
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Sep 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.