Healthcare Provider Details

I. General information

NPI: 1659285294
Provider Name (Legal Business Name): THE BIRTHWORK FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 GRAND CT
DAVENPORT IA
52803-2540
US

IV. Provider business mailing address

5245 ELMORE AVE
DAVENPORT IA
52807-3454
US

V. Phone/Fax

Practice location:
  • Phone: 515-661-7683
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. EBONIE BAILEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 515-661-7683