Provider Demographics
NPI:1285319939
Name:MOON CIRCLE MIDWIFERY AND WELLNESS, LLC
Entity type:Organization
Organization Name:MOON CIRCLE MIDWIFERY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNM/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARCIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:TOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:334-303-0409
Mailing Address - Street 1:9 W COURTLAND ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3954
Mailing Address - Country:US
Mailing Address - Phone:443-601-9266
Mailing Address - Fax:
Practice Address - Street 1:9 W COURTLAND ST STE 201
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3954
Practice Address - Country:US
Practice Address - Phone:443-601-9266
Practice Address - Fax:443-903-3665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty