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NPI Code Detail

MEDICARE: BEDROCK MIDWIFERY & WELLNESS, LLC

MEDICARE: BEDROCK MIDWIFERY & WELLNESS, LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife

General Provider Information

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

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Directions to “BEDROCK MIDWIFERY & WELLNESS, LLC ” Practice Location

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