Provider Demographics
NPI:1407829898
Name:NEW LIFE NURSE-MIDWIFERY CARE
Entity Type:Organization
Organization Name:NEW LIFE NURSE-MIDWIFERY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIETTA
Authorized Official - Middle Name:JANETTE
Authorized Official - Last Name:RENNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-642-1900
Mailing Address - Street 1:112 MOREY DR
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-1646
Mailing Address - Country:US
Mailing Address - Phone:937-642-1900
Mailing Address - Fax:937-578-2549
Practice Address - Street 1:112 MOREY DR
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-1646
Practice Address - Country:US
Practice Address - Phone:937-642-1900
Practice Address - Fax:937-578-2549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0976654Medicaid