# FERTILE GROUND MIDWIFERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245095835
- **Authorized official:** TIFINI AUSTIN (CEO)
- **Authorized official phone:** (850) 296-7086

## Contact information

- **Practice address:** 6130 TRAILWOOD CT, TALLAHASSEE, FL 32311-9389
- **Practice address phone:** (850) 296-7086
- **Practice address fax:** (850) 792-1354
- **Mailing address:** 2241 N MONROE ST \# 1295, TALLAHASSEE, FL 32303-4731
- **Mailing address phone:** (850) 296-7086
- **Mailing address fax:** (850) 792-1354

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 176B00000X | Midwife | — | NULL | Yes |
| 176B00000X | Midwife | — | — | Yes |

## Other

- **Enumeration date:** 02/14/2024
- **Last updated:** 02/14/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 110520600 | — | FL |