Organization
LUNA WOMEN'S WELLNESS AND BIRTH CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLLE MARIE UBAN PHD, APRN, CNM (OWNER/MIDWIFE DIRECTOR)
(218) 828-7773
Entity
Organization
Contact information
Practice address
117 GILLIS AVE NE, BRAINERD, MN 56401-3131
(218) 828-7773
(218) 828-2976
Mailing address
117 GILLIS AVE NE, BRAINERD, MN 56401
(218) 828-7773
Taxonomy
Speciality
Code
Description
License number
State
261QB0400X
Birthing Clinic/Center
Primary
32831
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902103658
INDIVIDUAL NPI
MN
Enumeration date
10/25/2016
Last updated
07/21/2022
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