Healthcare Provider Details

I. General information

NPI: 1972207868
Provider Name (Legal Business Name): THE BIRTH TRIBE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 07/19/2025
Certification Date: 07/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8635 W SAHARA AVE UNIT 4144
LAS VEGAS NV
89117-5858
US

IV. Provider business mailing address

8635 W SAHARA AVE UNIT 4144
LAS VEGAS NV
89117-5858
US

V. Phone/Fax

Practice location:
  • Phone: 702-779-3121
  • Fax:
Mailing address:
  • Phone: 702-779-3121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: EDNALYNA MARTIN
Title or Position: OWNER
Credential: CD-L, IBCLC
Phone: 702-779-3121