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General NPI Number Information
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NPI Number | 1154913853
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Entity Type | Organization
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Legal Business Name | MIDWIFERY & WOMEN'S WELLNESS CENTER NV, LLC
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 332 S JONES BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89107-2623
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Country | US
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Telephone | 702-861-6884
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Fax |
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Provider Business Mailing Address
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Address Line | 304 S JONES BLVD STE 3949
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City | LAS VEGAS
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State | NV
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Zip | 89107-2623
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAROL GINEE' REDDICK
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Credential | APRN
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Telephone | 904-327-2183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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