Provider Demographics
NPI:1497463087
Name:HOMEBODY MIDWIFERY
Entity Type:Organization
Organization Name:HOMEBODY MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LM
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:BRIGID
Authorized Official - Last Name:CONWAY-O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:707-695-1831
Mailing Address - Street 1:514A PETERSEN LN
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-1730
Mailing Address - Country:US
Mailing Address - Phone:707-695-1831
Mailing Address - Fax:
Practice Address - Street 1:7 BRIGHTON BLVD
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-5064
Practice Address - Country:US
Practice Address - Phone:514-847-7001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty