Healthcare Provider Details

I. General information

NPI: 1568387363
Provider Name (Legal Business Name): RURAL HEART MIDWIFERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

373 W RANCH TRL
GLENCOE AR
72539-7006
US

IV. Provider business mailing address

373 W RANCH TRL
GLENCOE AR
72539-7006
US

V. Phone/Fax

Practice location:
  • Phone: 870-710-3711
  • Fax:
Mailing address:
  • Phone: 870-710-3711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: CANEA ANN WEST
Title or Position: SOLE MEMBER
Credential: CNM,APRN
Phone: 870-710-3711