Healthcare Provider Details

I. General information

NPI: 1285240689
Provider Name (Legal Business Name): JOURNEY MIDWIVES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2020
Last Update Date: 09/21/2020
Certification Date: 09/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 NEW LA GRANGE RD
LOUISVILLE KY
40222-4812
US

IV. Provider business mailing address

7300 NEW LA GRANGE RD
LOUISVILLE KY
40222-4812
US

V. Phone/Fax

Practice location:
  • Phone: 23-833-9125
  • Fax:
Mailing address:
  • Phone: 23-833-9125
  • 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: JESSICA DEIS
Title or Position: CNM/OWNER
Credential: CNM
Phone: 502-432-6424