Healthcare Provider Details
I. General information
NPI: 1285576801
Provider Name (Legal Business Name): OUR WAY WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5622 W PALMAIRE AVE
GLENDALE AZ
85301-2510
US
IV. Provider business mailing address
PO BOX 73494
PHOENIX AZ
85050-1042
US
V. Phone/Fax
- Phone: 480-648-4161
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KIM
FLANDERS
Title or Position: OWNER, CNM
Credential: DNP, CNM
Phone: 480-648-4161