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Organization

MIRACLE MIDWIFERY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTA LYNN MIRACLE CPM, LM (MIDWIFE)
(801) 923-8806
Entity
Organization

Contact information

Practice address
360 S FORT LN STE 1B, LAYTON, UT 84041-5700
(801) 923-8806
(801) 447-6037
Mailing address
360 S FORT LN STE 1B, LAYTON, UT 84041-5700
(801) 923-8806

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
261QB0400X
Birthing Clinic/Center
Primary
261QC1500X
Community Health Clinic/Center

Other

Enumeration date
05/30/2019
Last updated
05/30/2019
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