Provider Demographics
NPI:1679643498
Name:WOMEN & BIRTH CARE
Entity Type:Organization
Organization Name:WOMEN & BIRTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCINNIS
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:801-278-3102
Mailing Address - Street 1:2180 E 4500 S
Mailing Address - Street 2:STE 150
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117
Mailing Address - Country:US
Mailing Address - Phone:801-278-3102
Mailing Address - Fax:801-278-3660
Practice Address - Street 1:2180 E 4500 S
Practice Address - Street 2:STE 150
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117
Practice Address - Country:US
Practice Address - Phone:801-278-3102
Practice Address - Fax:801-278-3660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT47473784402176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT72884OtherPEHP
UT47473784400001OtherBCBS
UT47473784400001OtherBCBS
UT72884OtherPEHP