1912146440 NPI number — NEW BEGINNINGS MIDWIFERY INC

Table of content: DR. KELLIE MAY DELLI COLLI PH.D. (NPI 1649407271)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912146440 NPI number — NEW BEGINNINGS MIDWIFERY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW BEGINNINGS MIDWIFERY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
A WOMAN'S PLACE FOR WELLNESS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912146440
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
439 WILSON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SATELLITE BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32937-2937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-779-0687
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
476 HIGHWAY A1A
Provider Second Line Business Practice Location Address:
STE 2A
Provider Business Practice Location Address City Name:
SATELLITE BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32937-2331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-779-0687
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2009

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
321-799-0687

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X , with the licence number:  ARNP1949352 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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