Healthcare Provider Details

I. General information

NPI: 1942713458
Provider Name (Legal Business Name): THREE SISTERS MIDWIFERY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 11/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 N SHEPPARD ST
RICHMOND VA
23221-1719
US

IV. Provider business mailing address

905 N SHEPPARD ST
RICHMOND VA
23221-1719
US

V. Phone/Fax

Practice location:
  • Phone: 804-537-2676
  • Fax: 804-409-1022
Mailing address:
  • Phone: 804-537-2676
  • Fax: 804-409-1022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number0129000112
License Number StateVA

VIII. Authorized Official

Name: MRS. GLENDA TURNER
Title or Position: MIDWIFE
Credential: CPM, LM
Phone: 804-537-2676