Healthcare Provider Details

I. General information

NPI: 1922933803
Provider Name (Legal Business Name): WILD WOMB MIDWIFERY & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 E MAIN ST
SANTAQUIN UT
84655-7045
US

IV. Provider business mailing address

847 E 9600 S
SALEM UT
84653-5566
US

V. Phone/Fax

Practice location:
  • Phone: 385-456-3340
  • Fax:
Mailing address:
  • Phone: 385-456-3340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRANDI SAIR
Title or Position: MIDWIFE
Credential: CPM,LDEM
Phone: 385-456-3340