Healthcare Provider Details

I. General information

NPI: 1548616659
Provider Name (Legal Business Name): THREADS OF LIFE MIDWIFERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2016
Last Update Date: 05/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 SCHOOL RD
JACOBUS PA
17407-1365
US

IV. Provider business mailing address

755 SCHOOL RD
JACOBUS PA
17407-1365
US

V. Phone/Fax

Practice location:
  • Phone: 717-424-4478
  • Fax: 866-243-1878
Mailing address:
  • Phone: 717-424-4478
  • Fax: 866-243-1878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PAULA HOSTLER
Title or Position: MEMBER
Credential:
Phone: 717-424-4478