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General NPI Number Information
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NPI Number | 1023426616
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Entity Type | Organization
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Legal Business Name | WONDERFULLY MADE MIDWIFERY CARE, LLC
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Dates
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Enumeration Date | 07/26/2014
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Last Update Date | 10/09/2015
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Provider Practice Location Address
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Address Line | 7646 BULLS HEAD DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-7046
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Country | US
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Telephone | 813-506-1823
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Fax |
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Provider Business Mailing Address
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Address Line | 7646 BULLS HEAD DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-7046
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Country | US
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Telephone | 813-506-1823
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHRYN MILLER
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Credential | LM, CPM
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Telephone | 813-506-1823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | MW278
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License Number State | FL
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