Healthcare Provider Details

I. General information

NPI: 1063701985
Provider Name (Legal Business Name): MIDWIVES OF KANSAS CITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2011
Last Update Date: 08/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6115 NIEMAN RD
SHAWNEE KS
66203-2939
US

IV. Provider business mailing address

6115 NIEMAN RD
SHAWNEE KS
66203-2939
US

V. Phone/Fax

Practice location:
  • Phone: 877-551-0001
  • Fax:
Mailing address:
  • Phone: 877-551-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number0068275-001
License Number StateKS

VIII. Authorized Official

Name: SUZANNE RYAN
Title or Position: DIRECTOR
Credential: CNM
Phone: 913-547-1495