Healthcare Provider Details

I. General information

NPI: 1063255966
Provider Name (Legal Business Name): LAWRENCE BIRTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2024
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: 785-925-2415
  • Fax:
Mailing address:
  • Phone: 785-856-0017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: JODIE MAYFIELD
Title or Position: OWNER
Credential: APRN, CNM
Phone: 785-925-2415