Provider Demographics
NPI:1730631300
Name:WOMEN'S HEALTH AND BIRTH CARE
Entity type:Organization
Organization Name:WOMEN'S HEALTH AND BIRTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP CNM WHNP
Authorized Official - Phone:801-695-1318
Mailing Address - Street 1:1205 E 2325 N
Mailing Address - Street 2:
Mailing Address - City:NORTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84414-2570
Mailing Address - Country:US
Mailing Address - Phone:801-695-1318
Mailing Address - Fax:
Practice Address - Street 1:2727 N WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:NORTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84414-2241
Practice Address - Country:US
Practice Address - Phone:801-695-1318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3203688900363LW0102X
UT320368-4402367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty