Healthcare Provider Details

I. General information

NPI: 1639792336
Provider Name (Legal Business Name): HOME BIRTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 05/28/2020
Certification Date: 05/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 EDENWOOD LN
NORTH LITTLE ROCK AR
72116-5106
US

IV. Provider business mailing address

6 EDENWOOD LN
NORTH LITTLE ROCK AR
72116-5106
US

V. Phone/Fax

Practice location:
  • Phone: 501-350-1520
  • Fax: 501-833-3322
Mailing address:
  • Phone: 501-350-1520
  • Fax: 501-833-3322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBORAH ROSE PHILLIPS
Title or Position: MIDWIFE
Credential: CPM, LLM
Phone: 501-350-1520