Provider Demographics
NPI:1548966153
Name:GIFTED HANDS MIDWIFERY
Entity type:Organization
Organization Name:GIFTED HANDS MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KWAJALEIN
Authorized Official - Middle Name:RONTOYA
Authorized Official - Last Name:CLEVELAND
Authorized Official - Suffix:
Authorized Official - Credentials:NPRN, CNM
Authorized Official - Phone:470-504-3856
Mailing Address - Street 1:3905 HARRISON RD STE 500
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-5895
Mailing Address - Country:US
Mailing Address - Phone:470-504-3856
Mailing Address - Fax:
Practice Address - Street 1:3905 HARRISON RD STE 500
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-5895
Practice Address - Country:US
Practice Address - Phone:470-504-3856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN190949OtherRN190949