Healthcare Provider Details

I. General information

NPI: 1275993719
Provider Name (Legal Business Name): GREAT EXPECTATIONS MIDWIFERY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2016
Last Update Date: 02/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 W WARM SPRINGS RD SUITE 136
HENDERSON NV
89014-7633
US

IV. Provider business mailing address

1481 W WARM SPRINGS RD SUITE 136
HENDERSON NV
89014-7633
US

V. Phone/Fax

Practice location:
  • Phone: 702-281-8482
  • Fax: 702-736-6247
Mailing address:
  • Phone: 702-281-8482
  • Fax: 702-736-6247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BONNIE ALLYSON JUNEAU-BUTLER
Title or Position: OWNER/MIDWIFE
Credential:
Phone: 702-281-8482