Healthcare Provider Details

I. General information

NPI: 1417404229
Provider Name (Legal Business Name): COMMUNITY MIDWIFERY SERVICES. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 09/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 W MAIN ST
NORMAN OK
73069-6459
US

IV. Provider business mailing address

2121 W MAIN ST
NORMAN OK
73069-6459
US

V. Phone/Fax

Practice location:
  • Phone: 405-447-9433
  • Fax:
Mailing address:
  • Phone: 405-447-9433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE HERNANDEZ
Title or Position: OWNER
Credential:
Phone: 405-447-9433