Healthcare Provider Details
I. General information
NPI: 1922987825
Provider Name (Legal Business Name): THE BIRTH COLLABORATIVE LAS VEGAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1590 SOMBRERO DR
LAS VEGAS NV
89169-2523
US
IV. Provider business mailing address
1590 SOMBRERO DR
LAS VEGAS NV
89169-2523
US
V. Phone/Fax
- Phone: 702-524-9705
- Fax:
- Phone: 702-524-9705
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174N00000X |
| Taxonomy | Lactation Consultant (Non-RN) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175M00000X |
| Taxonomy | Lay Midwife |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 374J00000X |
| Taxonomy | Doula |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
JOLLINA
SIMPSON
Title or Position: FOUNDER
Credential:
Phone: 702-524-9705