Healthcare Provider Details

I. General information

NPI: 1801144720
Provider Name (Legal Business Name): SARAH GRACE WEBSTER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2012
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 CHURCHMANS RD STE 101
NEWARK DE
19702-1945
US

IV. Provider business mailing address

620 CHURCHMANS RD STE 101
NEWARK DE
19702-1945
US

V. Phone/Fax

Practice location:
  • Phone: 302-658-2229
  • Fax:
Mailing address:
  • Phone: 302-658-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLK-0000163
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberLK-0000163
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: