Provider Demographics
NPI:1083090831
Name:BIRTHING YOUR WAY
Entity Type:Organization
Organization Name:BIRTHING YOUR WAY
Other - Org Name:BIRTHING YOUR WAY-MIDWIVES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SHELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LDEM
Authorized Official - Phone:801-796-2229
Mailing Address - Street 1:394 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-2052
Mailing Address - Country:US
Mailing Address - Phone:801-796-2229
Mailing Address - Fax:800-714-4718
Practice Address - Street 1:394 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-2052
Practice Address - Country:US
Practice Address - Phone:801-796-2229
Practice Address - Fax:800-714-4718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT52510964402367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty