MEDICARE: HAVEN WOMEN'S CARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	176B00000X	Midwife
2	374J00000X	Doula
3	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1699633578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAVEN WOMEN'S CARE LLC

Provider Business Mailing Address
First Line	:	5420 W SAHARA AVE STE 201
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0389
Country	:	US
Telephone Number	:	888-683-2584
Fax Number	:	888-683-2567

Provider Business Practice Location Address
First Line	:	2741 W FOND DU LAC AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53210-2624
Country	:	US
Telephone Number	:	414-867-3553
Fax Number	:	414-867-3633

Authorized Official
Title or Position	:	CEO
Name	:	KANDYACE MORRIS
Credential	:
Telephone Number	:	702-830-5325

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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