Provider Demographics
NPI:1588025977
Name:MIDWIFE PRISCILLA, LLC
Entity Type:Organization
Organization Name:MIDWIFE PRISCILLA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MANAGER, LICENSED MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:407-473-1882
Mailing Address - Street 1:1620 PLATT RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-2483
Mailing Address - Country:US
Mailing Address - Phone:407-473-1882
Mailing Address - Fax:
Practice Address - Street 1:1620 PLATT RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-2483
Practice Address - Country:US
Practice Address - Phone:407-473-1882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW263251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health