MEDICARE: CRADLE OF LOVE HOME BIRTH & WOMEN'S HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	APRN002028	NV

General Provider Information

NPI Number	:	1134641756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRADLE OF LOVE HOME BIRTH & WOMEN'S HEALTH

Provider Business Mailing Address
First Line	:	9029 FEATHER RIVER CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2366
Country	:	US
Telephone Number	:	702-778-4976
Fax Number	:

Provider Business Practice Location Address
First Line	:	9029 FEATHER RIVER CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2366
Country	:	US
Telephone Number	:	702-778-4976
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	LORRAINE GARCIA
Credential	:	CNM
Telephone Number	:	702-778-4976

Provider Enumeration Date	:	07/14/2017
Last Update Date	:	07/21/2022

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