Provider Demographics
NPI:1346601671
Name:NEW LIFE MIWIFERY SERVICES
Entity Type:Organization
Organization Name:NEW LIFE MIWIFERY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KRANENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:CPM
Authorized Official - Phone:305-338-0348
Mailing Address - Street 1:6934 WESTON RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2625
Mailing Address - Country:US
Mailing Address - Phone:305-338-0348
Mailing Address - Fax:
Practice Address - Street 1:6934 WESTON RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2625
Practice Address - Country:US
Practice Address - Phone:305-338-0348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing