MEDICARE: PEACEFUL PREGNANCY PATHWAYS LLC

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	176B00000X	Midwife

General Provider Information

NPI Number	:	1336423151
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACEFUL PREGNANCY PATHWAYS LLC

Provider Business Mailing Address
First Line	:	1901 NW 81ST AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-6236
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 NW 81ST AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-6236
Country	:	US
Telephone Number	:	954-780-9033
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	GELENA HINKLEY
Credential	:
Telephone Number	:	954-780-9033

Provider Enumeration Date	:	09/29/2011
Last Update Date	:	09/29/2011

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