Provider Demographics
NPI:1275075814
Name:BUNDLEBORN MIDWIFERY
Entity Type:Organization
Organization Name:BUNDLEBORN MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERI
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CNM, IBCLC
Authorized Official - Phone:469-850-2661
Mailing Address - Street 1:7258 ELM ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5747
Mailing Address - Country:US
Mailing Address - Phone:469-850-2661
Mailing Address - Fax:214-292-6520
Practice Address - Street 1:7258 ELM ST
Practice Address - Street 2:SUITE A
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5747
Practice Address - Country:US
Practice Address - Phone:469-850-2661
Practice Address - Fax:214-292-6520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center