Provider Demographics
NPI:1528158243
Name:INANNA BIRTH & WOMEN'S CARE, INC
Entity type:Organization
Organization Name:INANNA BIRTH & WOMEN'S CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEWTERBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-483-1569
Mailing Address - Street 1:1823 N LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-3069
Mailing Address - Country:US
Mailing Address - Phone:940-483-1569
Mailing Address - Fax:940-483-1570
Practice Address - Street 1:1823 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-3069
Practice Address - Country:US
Practice Address - Phone:940-483-1569
Practice Address - Fax:940-483-1570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004943261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004943OtherSTATE LICENSE
TXHH1615OtherBLUE CROSS BLUE SHIELD