Healthcare Provider Details

I. General information

NPI: 1053142182
Provider Name (Legal Business Name): LAWRENCE BIRTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2024
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 ROCKLEDGE RD
LAWRENCE KS
66049-2562
US

IV. Provider business mailing address

515 ROCKLEDGE RD
LAWRENCE KS
66049-2562
US

V. Phone/Fax

Practice location:
  • Phone: 785-856-0017
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JODIE A MAYFIELD
Title or Position: OWNER
Credential:
Phone: 785-856-0017