Provider Demographics
NPI:1992165294
Name:NU LIFE MIDWIFERY
Entity type:Organization
Organization Name:NU LIFE MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:352-598-4703
Mailing Address - Street 1:7479 GATHERING LOOP
Mailing Address - Street 2:
Mailing Address - City:REUNION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-6702
Mailing Address - Country:US
Mailing Address - Phone:352-598-4703
Mailing Address - Fax:813-433-5571
Practice Address - Street 1:7479 GATHERING LOOP
Practice Address - Street 2:
Practice Address - City:REUNION
Practice Address - State:FL
Practice Address - Zip Code:34747-6702
Practice Address - Country:US
Practice Address - Phone:352-598-4703
Practice Address - Fax:813-433-5571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW299176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013364900Medicaid