Organization
BLOSSOM BIRTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICHELLE WHITEHEAD M.D (LEAD PHYSICIAN)
(602) 256-7766
Entity
Organization
Contact information
Practice address
2928 N 18TH PL, PHOENIX, AZ 85016-7705
(623) 322-0730
(623) 374-4592
Mailing address
2928 N 18TH PL, PHOENIX, AZ 85016-7705
(623) 322-0730
(623) 374-4592
Taxonomy
Speciality
Code
Description
License number
State
261QB0400X
Birthing Clinic/Center
Primary
OTC4901
AZ
Other
Enumeration date
02/14/2012
Last updated
02/14/2012
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