Provider Demographics
NPI:1235609918
Name:DRAGONFLY MIDWIFERY LLC
Entity Type:Organization
Organization Name:DRAGONFLY MIDWIFERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:CPM, LTM
Authorized Official - Phone:320-290-1496
Mailing Address - Street 1:3035 BRYANT AVE S # 101
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2828
Mailing Address - Country:US
Mailing Address - Phone:320-290-1496
Mailing Address - Fax:651-461-6690
Practice Address - Street 1:1619 DAYTON AVE STE 316
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-6276
Practice Address - Country:US
Practice Address - Phone:320-290-1496
Practice Address - Fax:651-461-6690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty