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General NPI Number Information
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NPI Number | 1306161302
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Entity Type | Organization
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Legal Business Name | BROOKHAVEN HEALTH AND NATURAL BIRTH CENTER
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Dates
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Enumeration Date | 04/01/2010
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Last Update Date | 04/01/2010
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Provider Practice Location Address
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Address Line | 1461 BROOKHAVEN DR
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City | HARRISONBURG
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State | VA
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Zip | 22801-3584
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Country | US
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Telephone | 540-830-4462
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Fax |
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Provider Business Mailing Address
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Address Line | 8729 CHESTERFIELD LN
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City | BRIDGEWATER
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State | VA
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Zip | 22812-3725
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Country | US
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Telephone | 540-830-4462
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Fax |
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Authorized Official
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Title or Position | MIDWIFE
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Name | MISTY DAWN WARD
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Credential | CPM
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Telephone | 540-830-4462
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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 | 0129000054
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License Number State | VA
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