Healthcare Provider Details

I. General information

NPI: 1174485262
Provider Name (Legal Business Name): LIFEBLOOM MIDWIFERY AND FAMILY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 S GRAND AVE
MOUNT PLEASANT IA
52641-1843
US

IV. Provider business mailing address

520 S GRAND AVE
MOUNT PLEASANT IA
52641-1843
US

V. Phone/Fax

Practice location:
  • Phone: 319-204-5856
  • Fax:
Mailing address:
  • Phone: 319-204-5856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LORENA DEJEAN ALLEN
Title or Position: OWNER
Credential: ARNP
Phone: 319-759-7642