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General NPI Number Information
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NPI Number | 1770910721
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Entity Type | Organization
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Legal Business Name | MIDWIVES COOPERATIVE LLC
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Dates
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Enumeration Date | 10/07/2013
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 5310 NW 8TH AVE STE 1
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City | GAINESVILLE
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State | FL
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Zip | 32605-4468
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Country | US
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Telephone | 352-377-3879
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Fax | 386-462-9021
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Provider Business Mailing Address
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Address Line | 5310 NW 8TH AVE STE 1
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City | GAINESVILLE
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State | FL
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Zip | 32605-4468
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Country | US
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Telephone | 352-377-3879
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Fax | 352-478-0175
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Authorized Official
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Title or Position | OWNER, LICENSED MIDWIFE
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Name | ABIGAIL OWENS-REICHARDT
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Credential | LM
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Telephone | 352-377-3879
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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 |
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License Number State |
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