Provider Demographics
NPI:1497270763
Name:THE NEST BIRTH CENTER, PLLC
Entity Type:Organization
Organization Name:THE NEST BIRTH CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIELL
Authorized Official - Suffix:
Authorized Official - Credentials:CPM, LM
Authorized Official - Phone:817-691-0856
Mailing Address - Street 1:208 E. BROAD STREET
Mailing Address - Street 2:104
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-1790
Mailing Address - Country:US
Mailing Address - Phone:817-691-0856
Mailing Address - Fax:817-691-0856
Practice Address - Street 1:208 E BROAD ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7703
Practice Address - Country:US
Practice Address - Phone:817-691-0856
Practice Address - Fax:817-549-2575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE NEST BIRTH CENTER, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX999233261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing