Provider Demographics
NPI:1154918084
Name:INNATE MIDWIFERY LLC
Entity type:Organization
Organization Name:INNATE MIDWIFERY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIA
Authorized Official - Middle Name:
Authorized Official - Last Name:L'ECUYER
Authorized Official - Suffix:
Authorized Official - Credentials:CPM, LDEM
Authorized Official - Phone:888-755-7155
Mailing Address - Street 1:4359 S HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3539
Mailing Address - Country:US
Mailing Address - Phone:888-755-7155
Mailing Address - Fax:801-723-3115
Practice Address - Street 1:4359 S HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84124-3539
Practice Address - Country:US
Practice Address - Phone:888-755-7155
Practice Address - Fax:801-723-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-26
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty