Healthcare Provider Details

I. General information

NPI: 1962432989
Provider Name (Legal Business Name): BIRTH COTTAGE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E 6TH AVE
TALLAHASSEE FL
32303-6208
US

IV. Provider business mailing address

260 E 6TH AVE
TALLAHASSEE FL
32303-6208
US

V. Phone/Fax

Practice location:
  • Phone: 850-224-2229
  • Fax: 850-681-6969
Mailing address:
  • Phone: 850-224-2229
  • Fax: 850-681-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number306
License Number StateFL

VIII. Authorized Official

Name: MRS. LAYLA M SWISHER
Title or Position: MIDWIFE
Credential: LM, CPM
Phone: 850-681-6969