Provider Demographics
NPI:1356073282
Name:AURORA MIDWIFERY LLC
Entity Type:Organization
Organization Name:AURORA MIDWIFERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TESA
Authorized Official - Middle Name:LENEE
Authorized Official - Last Name:LUBANS DEHAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:LM CPM
Authorized Official - Phone:303-845-0630
Mailing Address - Street 1:PO BOX 585
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS CITY
Mailing Address - State:CA
Mailing Address - Zip Code:96024-0585
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 TAYLOR STREET
Practice Address - Street 2:SUITE C
Practice Address - City:WEAVERVILLE
Practice Address - State:CA
Practice Address - Zip Code:96093
Practice Address - Country:US
Practice Address - Phone:530-423-5105
Practice Address - Fax:530-503-9803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA664OtherCA LM