Healthcare Provider Details

I. General information

NPI: 1750773834
Provider Name (Legal Business Name): CONFLUENCE MIDWIFERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2015
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3271 ROGER PL
SAINT LOUIS MO
63116-3838
US

IV. Provider business mailing address

3844 UTAH PL
SAINT LOUIS MO
63116-4833
US

V. Phone/Fax

Practice location:
  • Phone: 314-677-9998
  • Fax:
Mailing address:
  • Phone: 314-677-9998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: LINSEY KORNYA
Title or Position: OWNER
Credential:
Phone: 314-677-9998