=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972260073
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEART AND HANDS MATERNITY AND WELLNESS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/23/2021
-----------------------------------------------------
Last Update Date | 11/23/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 659 S 1160 W
-----------------------------------------------------
City | OREM
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84058-5908
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-427-8639
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 659 S 1160 W
-----------------------------------------------------
City | OREM
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84058-5908
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-427-8639
-----------------------------------------------------
Fax | 801-877-5359
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MIDWIFE
-----------------------------------------------------
Name | ANGELLA MENDENHALL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 801-427-8639
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QB0400X
-----------------------------------------------------
Taxonomy Name | Birthing Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------