Provider Demographics
NPI:1396570156
Name:BRAVE KNIGHT ENTERPRISES
Entity type:Organization
Organization Name:BRAVE KNIGHT ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ELKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MIDWIFE
Authorized Official - Phone:806-626-4963
Mailing Address - Street 1:1200 SW 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79102-2613
Mailing Address - Country:US
Mailing Address - Phone:806-772-6431
Mailing Address - Fax:806-517-2254
Practice Address - Street 1:1200 SW 15TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79102-2613
Practice Address - Country:US
Practice Address - Phone:806-772-6431
Practice Address - Fax:806-517-2254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing