Provider Demographics
NPI:1285240689
Name:JOURNEY MIDWIVES, LLC
Entity type:Organization
Organization Name:JOURNEY MIDWIVES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNM/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEIS
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:502-432-6424
Mailing Address - Street 1:7300 NEW LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4812
Mailing Address - Country:US
Mailing Address - Phone:023-833-9125
Mailing Address - Fax:
Practice Address - Street 1:7300 NEW LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4812
Practice Address - Country:US
Practice Address - Phone:023-833-9125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty