Provider Demographics
NPI:1376855023
Name:WOMEN FIRST OB GYN PLLC
Entity Type:Organization
Organization Name:WOMEN FIRST OB GYN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:MCLAURIN
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:252-338-9080
Mailing Address - Street 1:1177 NORTH ROAD STREET
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-4472
Mailing Address - Country:US
Mailing Address - Phone:252-338-9080
Mailing Address - Fax:252-338-6712
Practice Address - Street 1:1177 NORTH ROAD STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-4472
Practice Address - Country:US
Practice Address - Phone:252-338-9080
Practice Address - Fax:252-338-6712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-10
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC108316176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891289XMedicaid
NC2287487AMedicare UPIN