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NPI Code Detail

MEDICARE: LA VITA BELLA BIRTH CENTER, PLLC

MEDICARE: LA VITA BELLA BIRTH CENTER, PLLC
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
1261QF0050XNon-Surgical Family Planning Clinic/Center
2261QB0400XBirthing Clinic/Center

General Provider Information

NPI Number : 1720609589
Entity Type Code : Organization
Provider Name (Legal Business Name) : LA VITA BELLA BIRTH CENTER, PLLC
Provider Business Mailing Address
First Line : 310 NEW BRIDGE ST
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28540-4756
Country : US
Telephone Number : 910-621-4266
Fax Number :
Provider Business Practice Location Address
First Line : 310 NEW BRIDGE ST
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28540-4756
Country : US
Telephone Number : 910-621-4266
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MICHELLE A RHUDE
Credential : CNM
Telephone Number : 910-621-4266
Provider Enumeration Date : 05/04/2020
Last Update Date : 09/13/2025

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