Healthcare Provider Details
I. General information
NPI: 1699535344
Provider Name (Legal Business Name): WOMEN'S HEALTH AND BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2024
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
226 ASHVILLE AVE STE 20
CARY NC
27518-6660
US
IV. Provider business mailing address
226 ASHVILLE AVE STE 20
CARY NC
27518-6660
US
V. Phone/Fax
- Phone: 919-322-0284
- Fax:
- Phone: 919-322-0284
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133NN1002X |
| Taxonomy | Nutrition Education Nutritionist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QF0050X |
| Taxonomy | Non-Surgical Family Planning Clinic/Center |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QB0400X |
| Taxonomy | Birthing Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SARA
FAWSON
Title or Position: CEO, CERTIFIED NURSE MIDWIFE
Credential: DNP CNM
Phone: 801-695-1318