Healthcare Provider Details

I. General information

NPI: 1912293655
Provider Name (Legal Business Name): NEW LIFE BIRTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 06/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 S MAIN ST
ROCKY MOUNT VA
24151-1751
US

IV. Provider business mailing address

610 S MAIN ST
ROCKY MOUNT VA
24151-1751
US

V. Phone/Fax

Practice location:
  • Phone: 540-798-4064
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAREN WINSTEAD
Title or Position: PRESIDENT
Credential: CNM
Phone: 540-798-4064