MEDICARE: PEACE BIRTH AND WELLNESS

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
1	367A00000X	Advanced Practice Midwife

General Provider Information

NPI Number	:	1891304028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE BIRTH AND WELLNESS

Provider Business Mailing Address
First Line	:	615 OAK SHADE AVE
Second Line	:
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-1713
Country	:	US
Telephone Number	:	267-977-6823
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 OAK SHADE AVE
Second Line	:
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-1713
Country	:	US
Telephone Number	:	267-977-6823
Fax Number	:

Authorized Official
Title or Position	:	MIDWIFE DIRECTOR
Name	:	KAMIL EL
Credential	:	CNM
Telephone Number	:	267-977-6823

Provider Enumeration Date	:	07/23/2020
Last Update Date	:	08/15/2020

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Directions to “PEACE BIRTH AND WELLNESS ” Practice Location

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