Provider Demographics
NPI:1982149894
Name:MODERN DAY MIDWIFERY LLC
Entity Type:Organization
Organization Name:MODERN DAY MIDWIFERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BIRTH DOULA APPRENTICE MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:KRISTIN
Authorized Official - Last Name:REKUC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-812-9978
Mailing Address - Street 1:15596 THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-1948
Mailing Address - Country:US
Mailing Address - Phone:734-812-9978
Mailing Address - Fax:
Practice Address - Street 1:15596 THOMAS AVE
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-1948
Practice Address - Country:US
Practice Address - Phone:734-812-9978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-01
Last Update Date:2017-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency