Provider Demographics
NPI:1710453600
Name:MY SISTER'S KEEPER BIRTH & MIDWFERY SERVICES
Entity Type:Organization
Organization Name:MY SISTER'S KEEPER BIRTH & MIDWFERY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE
Authorized Official - Prefix:MS
Authorized Official - First Name:KENNASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:503-317-3414
Mailing Address - Street 1:3512 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-8644
Mailing Address - Country:US
Mailing Address - Phone:503-317-3414
Mailing Address - Fax:
Practice Address - Street 1:1726 CHADWICK CT STE 200
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3318
Practice Address - Country:US
Practice Address - Phone:817-479-0124
Practice Address - Fax:817-280-9962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty