Provider Demographics
NPI:1215820196
Name:SAGE WELLNESS BIRTH COLLABORATIVE
Entity type:Organization
Organization Name:SAGE WELLNESS BIRTH COLLABORATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:KIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:TOSI
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, APRN
Authorized Official - Phone:850-446-6505
Mailing Address - Street 1:831 MCCASKILL ST
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32536-2757
Mailing Address - Country:US
Mailing Address - Phone:850-446-6505
Mailing Address - Fax:850-806-1868
Practice Address - Street 1:831 MCCASKILL ST
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32536-2757
Practice Address - Country:US
Practice Address - Phone:850-446-6505
Practice Address - Fax:850-806-1868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty