Provider Demographics
NPI:1720601875
Name:JOY MIDWIFERY AND WOMEN'S HEALTH
Entity type:Organization
Organization Name:JOY MIDWIFERY AND WOMEN'S HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSE MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNAH
Authorized Official - Middle Name:16163 IN
Authorized Official - Last Name:OKUTORO-KETTER
Authorized Official - Suffix:
Authorized Official - Credentials:MSN CNM
Authorized Official - Phone:917-470-0518
Mailing Address - Street 1:3549 BAILEY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-8463
Mailing Address - Country:US
Mailing Address - Phone:917-470-0518
Mailing Address - Fax:
Practice Address - Street 1:3549 BAILEY RIDGE DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-8463
Practice Address - Country:US
Practice Address - Phone:917-470-0518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-23
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service