Provider Demographics
NPI:1285280941
Name:MIDWIFE LOUISIANA
Entity type:Organization
Organization Name:MIDWIFE LOUISIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HONEYCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:318-599-0579
Mailing Address - Street 1:253 UPCHURCH RD
Mailing Address - Street 2:
Mailing Address - City:DUBACH
Mailing Address - State:LA
Mailing Address - Zip Code:71235-2558
Mailing Address - Country:US
Mailing Address - Phone:318-599-0579
Mailing Address - Fax:318-284-8819
Practice Address - Street 1:253 UPCHURCH RD
Practice Address - Street 2:
Practice Address - City:DUBACH
Practice Address - State:LA
Practice Address - Zip Code:71235-2558
Practice Address - Country:US
Practice Address - Phone:318-599-0579
Practice Address - Fax:318-284-8819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty