Provider Demographics
NPI:1750162442
Name:NEW BIRTH WELLNESS CENTER
Entity type:Organization
Organization Name:NEW BIRTH WELLNESS CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:CPM, LM
Authorized Official - Phone:952-358-0010
Mailing Address - Street 1:1580 WHITE OAK DR STE 275
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-2927
Mailing Address - Country:US
Mailing Address - Phone:952-856-0071
Mailing Address - Fax:651-760-4303
Practice Address - Street 1:1580 WHITE OAK DR STE 275
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-2927
Practice Address - Country:US
Practice Address - Phone:952-856-0071
Practice Address - Fax:651-760-4303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthingGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty