Provider Demographics
NPI:1619650884
Name:LUNA MIDWIVES, INC
Entity Type:Organization
Organization Name:LUNA MIDWIVES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:MS
Authorized Official - First Name:DEGRA
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:NOFSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:CPM, LM
Authorized Official - Phone:540-312-0099
Mailing Address - Street 1:2511 STEPHENSON AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-1516
Mailing Address - Country:US
Mailing Address - Phone:540-312-0099
Mailing Address - Fax:540-685-2430
Practice Address - Street 1:1950 ELECTRIC RD LOWR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1621
Practice Address - Country:US
Practice Address - Phone:540-358-0341
Practice Address - Fax:540-685-2430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty