Provider Demographics
NPI:1225915234
Name:SOUTH SHORE HOME BIRTH MIDWIFERY & WOMEN'S WELLNESS, LLC
Entity type:Organization
Organization Name:SOUTH SHORE HOME BIRTH MIDWIFERY & WOMEN'S WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:CISNEROS
Authorized Official - Last Name:PEGHER
Authorized Official - Suffix:
Authorized Official - Credentials:CPM, LM
Authorized Official - Phone:781-812-9445
Mailing Address - Street 1:512 COUNTRY WAY
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-2408
Mailing Address - Country:US
Mailing Address - Phone:781-812-9445
Mailing Address - Fax:781-787-2416
Practice Address - Street 1:141 WASHINGTON ST STE 4
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1779
Practice Address - Country:US
Practice Address - Phone:781-812-9445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty