MEDICARE: VITALITY GENERATION & MIDWIFERY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	175M00000X	Lay Midwife
2	163W00000X	Registered Nurse
3	367A00000X	Advanced Practice Midwife
4	176B00000X	Midwife

General Provider Information

NPI Number	:	1336669100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITALITY GENERATION & MIDWIFERY LLC

Provider Business Mailing Address
First Line	:	431 E 2700 N
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84414-2332
Country	:	US
Telephone Number	:	801-628-4573
Fax Number	:	801-436-5182

Provider Business Practice Location Address
First Line	:	5319 S 500 E STE C
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84405-7218
Country	:	US
Telephone Number	:	801-917-6104
Fax Number	:	801-436-5182

Authorized Official
Title or Position	:	CEO
Name	:	MRS. LORETTA S. SHUPE
Credential	:	CPM
Telephone Number	:	801-628-4573

Provider Enumeration Date	:	06/22/2017
Last Update Date	:	10/06/2025

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Directions to “VITALITY GENERATION & MIDWIFERY LLC ” Practice Location

Language	Start Address	Practice Location

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