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General NPI Number Information
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NPI Number | 1215820196
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Entity Type | Organization
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Legal Business Name | SAGE WELLNESS BIRTH COLLABORATIVE
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 831 MCCASKILL ST
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City | CRESTVIEW
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State | FL
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Zip | 32536-2757
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Country | US
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Telephone | 850-446-6505
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Fax | 850-806-1868
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Provider Business Mailing Address
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Address Line | 831 MCCASKILL ST
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City | CRESTVIEW
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State | FL
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Zip | 32536-2757
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Country | US
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Telephone | 850-446-6505
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Fax | 850-806-1868
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Authorized Official
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Title or Position | OWNER, MIDWIFE
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Name | KIZ TOSI
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Credential | CNM, APRN
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Telephone | 850-446-6505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number |
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License Number State |
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