Provider Demographics
NPI:1497011159
Name:NORTHERN VIRGINIA NATURAL BIRTH CENTER AND WELLNESS COMMUNITY
Entity Type:Organization
Organization Name:NORTHERN VIRGINIA NATURAL BIRTH CENTER AND WELLNESS COMMUNITY
Other - Org Name:NOVA NATURAL BIRTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPM
Authorized Official - Phone:703-881-6767
Mailing Address - Street 1:14158 CLUBHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3808
Mailing Address - Country:US
Mailing Address - Phone:703-881-6767
Mailing Address - Fax:703-996-4104
Practice Address - Street 1:4200A TECHNOLOGY CT
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1214
Practice Address - Country:US
Practice Address - Phone:703-357-3808
Practice Address - Fax:888-770-0243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing