Healthcare Provider Details

I. General information

NPI: 1679482145
Provider Name (Legal Business Name): HARBOR MIDWIFERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SKIPWITH RD
RICHMOND VA
23229-4202
US

IV. Provider business mailing address

13719 ELMLEY CT
MIDLOTHIAN VA
23112-1370
US

V. Phone/Fax

Practice location:
  • Phone: 804-904-9057
  • Fax: 804-843-8602
Mailing address:
  • Phone: 317-508-9763
  • Fax: 804-843-8602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KELLY BECKER
Title or Position: OWNER
Credential: CNM
Phone: 317-508-9763