Healthcare Provider Details

I. General information

NPI: 1578388583
Provider Name (Legal Business Name): MITHRIL MINISTRATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 W JUBAL EARLY DR STE 203
WINCHESTER VA
22601-6435
US

IV. Provider business mailing address

420 W JUBAL EARLY DR STE 203
WINCHESTER VA
22601-6435
US

V. Phone/Fax

Practice location:
  • Phone: 540-908-2671
  • Fax: 540-808-4100
Mailing address:
  • Phone: 540-908-2671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HEATHER VOLLGRAFF BARRETT
Title or Position: OWNER
Credential: LM, CPM
Phone: 281-685-6945