Healthcare Provider Details

I. General information

NPI: 1457049785
Provider Name (Legal Business Name): BUMP BIRTH & BABY CO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 MONTANA AVE STE 207
EL PASO TX
79903-2421
US

IV. Provider business mailing address

2829 MONTANA AVE STE 207
EL PASO TX
79903-2421
US

V. Phone/Fax

Practice location:
  • Phone: 313-408-6657
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: SARAH WALBORN
Title or Position: OWNER/SOLE MEMBER
Credential: ICBD, CLC
Phone: 313-408-6657