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Organization
RIVERBEND MIDWIFERY, LLC
Active
Organization
RIVERBEND MIDWIFERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSALIE BLACKWELL LM (OWNER)
(386) 984-9716
Entity
Organization
Contact information
Practice address
2010 EVERGREEN AVE SW, LIVE OAK, FL 32064-4421
(386) 984-9716
(386) 401-2312
Mailing address
PO BOX 1002, LAKE CITY, FL 32056-1002
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
NULL
176B00000X
Midwife
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112949400
—
FL
Enumeration date
02/06/2023
Last updated
02/06/2023
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