Provider Demographics
NPI:1164909545
Name:REDEEMED CREATIONS MIDWIFERY SERVICES, PLLC
Entity Type:Organization
Organization Name:REDEEMED CREATIONS MIDWIFERY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TAYLOR SMALLS
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:347-663-1700
Mailing Address - Street 1:1042 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-5428
Mailing Address - Country:US
Mailing Address - Phone:347-663-1700
Mailing Address - Fax:347-663-1711
Practice Address - Street 1:1042 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-5428
Practice Address - Country:US
Practice Address - Phone:718-513-6510
Practice Address - Fax:718-513-6509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF0012301367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty