Healthcare Provider Details
I. General information
NPI: 1396315388
Provider Name (Legal Business Name): SAFE HAVEN MIDWIFERY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2021
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2505 S WALTER REED DR UNIT B
ARLINGTON VA
22206-1207
US
IV. Provider business mailing address
2505 S WALTER REED DR UNIT B
ARLINGTON VA
22206-1207
US
V. Phone/Fax
- Phone: 417-631-8292
- Fax:
- Phone: 417-631-8292
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CASEY
MORROW
Title or Position: OWNER
Credential: CNM
Phone: 417-631-8292