Provider Demographics
NPI:1700376860
Name:AUSTIN MIDWIFE PLLC
Entity Type:Organization
Organization Name:AUSTIN MIDWIFE PLLC
Other - Org Name:HOMEBIRTH IN AUSTIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:512-710-9662
Mailing Address - Street 1:1036 STOCKADE RANCH RD
Mailing Address - Street 2:
Mailing Address - City:PAIGE
Mailing Address - State:TX
Mailing Address - Zip Code:78659-4446
Mailing Address - Country:US
Mailing Address - Phone:512-710-9662
Mailing Address - Fax:
Practice Address - Street 1:1036 STOCKADE RANCH RD
Practice Address - Street 2:
Practice Address - City:PAIGE
Practice Address - State:TX
Practice Address - Zip Code:78659-4446
Practice Address - Country:US
Practice Address - Phone:512-710-9662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99330176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty