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General NPI Number Information
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NPI Number | 1578414637
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Entity Type | Organization
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Legal Business Name | BEDROCK MIDWIFERY & WELLNESS, LLC
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 5622 W PALMAIRE AVE
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City | GLENDALE
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State | AZ
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Zip | 85301-2510
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Country | US
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Telephone | 207-615-7297
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Fax |
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Provider Business Mailing Address
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Address Line | 5622 W PALMAIRE AVE
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City | GLENDALE
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State | AZ
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Zip | 85301-2510
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Country | US
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Telephone | 207-615-7297
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LARA EL-HOSS
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Credential | APRN, CNM
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Telephone | 207-615-7297
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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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