Provider Demographics
NPI:1619548500
Name:BIRTH YOUR WAY MIDWIFERY AND WOMEN'S WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:BIRTH YOUR WAY MIDWIFERY AND WOMEN'S WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CNM
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, APRN
Authorized Official - Phone:315-800-3213
Mailing Address - Street 1:330 W 23RD ST STE I
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4540
Mailing Address - Country:US
Mailing Address - Phone:315-800-3213
Mailing Address - Fax:
Practice Address - Street 1:330 W 23RD ST STE I
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4540
Practice Address - Country:US
Practice Address - Phone:315-800-3213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing