=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821877762
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TEMPE BIRTH CENTER, L.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2023
-----------------------------------------------------
Last Update Date | 09/28/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 914 SOUTH MILL AVENUE
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85281
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-647-2099
-----------------------------------------------------
Fax | 888-483-1215
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 918 SOUTH MILL AVENUE
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85281
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-647-2099
-----------------------------------------------------
Fax | 888-483-1215
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL MIDWIFERY DIRECTOR
-----------------------------------------------------
Name | KATHERINE ELAINE PAXTON, CNM
-----------------------------------------------------
Credential | CNM
-----------------------------------------------------
Telephone | 480-647-2099
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QB0400X
-----------------------------------------------------
Taxonomy Name | Birthing Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------