Healthcare Provider Details

I. General information

NPI: 1609209386
Provider Name (Legal Business Name): YOUR BIRTH MIDWIFERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 08/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 TIMBER VALLEY DR
NASHVILLE TN
37214-4236
US

IV. Provider business mailing address

1341 TIMBER VALLEY DR
NASHVILLE TN
37214-4236
US

V. Phone/Fax

Practice location:
  • Phone: 615-601-1079
  • Fax:
Mailing address:
  • Phone: 615-601-1079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. JORDAN CALLAHAN
Title or Position: MEMBER
Credential: CPM-TN, LM
Phone: 615-601-1079