Healthcare Provider Details

I. General information

NPI: 1245029248
Provider Name (Legal Business Name): WOVEN CARE WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 REED ST
GARDEN CITY ID
83714-6458
US

IV. Provider business mailing address

3920 REED ST
GARDEN CITY ID
83714-6458
US

V. Phone/Fax

Practice location:
  • Phone: 513-532-6622
  • Fax:
Mailing address:
  • Phone: 513-532-6622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TESS WEIDNER
Title or Position: CERTIFIED NURSE MIDWIFE -CO-OWNER
Credential: CNM
Phone: 513-532-6622