Provider Demographics
NPI:1013739176
Name:NOVA VIDA MIDWIVES, LLC
Entity type:Organization
Organization Name:NOVA VIDA MIDWIVES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SENIOR MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUXFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CPM-LDM
Authorized Official - Phone:541-992-3738
Mailing Address - Street 1:3013 N NORTH BANK RD
Mailing Address - Street 2:
Mailing Address - City:OTIS
Mailing Address - State:OR
Mailing Address - Zip Code:97368-9754
Mailing Address - Country:US
Mailing Address - Phone:541-992-3738
Mailing Address - Fax:
Practice Address - Street 1:3013 N NORTH BANK RD
Practice Address - Street 2:
Practice Address - City:OTIS
Practice Address - State:OR
Practice Address - Zip Code:97368-9754
Practice Address - Country:US
Practice Address - Phone:541-992-3738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOVA VIDA MIDWIVES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing