Healthcare Provider Details

I. General information

NPI: 1205344108
Provider Name (Legal Business Name): NOVA BIRTH PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2018
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10560 MAIN ST STE 417
FAIRFAX VA
22030-7174
US

IV. Provider business mailing address

10560 MAIN ST STE 417
FAIRFAX VA
22030-7174
US

V. Phone/Fax

Practice location:
  • Phone: 571-406-7705
  • Fax: 571-406-7705
Mailing address:
  • Phone: 571-406-7705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: FAITH RAMIREZ
Title or Position: CEO
Credential:
Phone: 571-406-7705