Organization
MERMAID BIRTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE M CHANCELLOR-CHECKETTS CPM-LDEM (OWNER/MIDWIFE)
(801) 643-0604
Entity
Organization
Contact information
Practice address
48 S 100 E, BRIGHAM CITY, UT 84302-2642
(801) 643-0604
(435) 279-9092
Mailing address
48 S 100 E, BRIGHAM CITY, UT 84302-2642
(801) 643-0604
(435) 279-9092
Taxonomy
Speciality
Code
Description
License number
State
261QB0400X
Birthing Clinic/Center
Primary
UT000782
UT
Other
Enumeration date
02/19/2014
Last updated
11/16/2016
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