Healthcare Provider Details

I. General information

NPI: 1720991003
Provider Name (Legal Business Name): GEORGETOWN BIRTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EASTSIDE DR
GEORGETOWN KY
40324-9797
US

IV. Provider business mailing address

100 EASTSIDE DR
GEORGETOWN KY
40324-9797
US

V. Phone/Fax

Practice location:
  • Phone: 701-638-1372
  • 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

VIII. Authorized Official

Name: ELIZABETH REGAN
Title or Position: OWNER, CLINICAL DIRECTOR
Credential: LCPM
Phone: 701-638-1372