Provider Demographics
NPI:1962024877
Name:DC MOBILE MIDWIFE LLC
Entity Type:Organization
Organization Name:DC MOBILE MIDWIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CERTIFIED NURSE MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:202-630-7177
Mailing Address - Street 1:5518 8TH ST S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-2616
Mailing Address - Country:US
Mailing Address - Phone:202-630-7177
Mailing Address - Fax:
Practice Address - Street 1:5227 CHILLUM PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-6417
Practice Address - Country:US
Practice Address - Phone:202-630-7177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care