Healthcare Provider Details

I. General information

NPI: 1346852241
Provider Name (Legal Business Name): BALANCE MIDWIFERY AND WOMEN'S HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 N GREENFIELD RD STE 101
GILBERT AZ
85234-5044
US

IV. Provider business mailing address

875 N GREENFIELD RD STE 101
GILBERT AZ
85234-5044
US

V. Phone/Fax

Practice location:
  • Phone: 480-664-7463
  • Fax: 480-664-7467
Mailing address:
  • Phone: 480-664-7463
  • Fax: 480-664-7467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KARIN BRAUN
Title or Position: OWNER
Credential: CNM
Phone: 480-848-3182