Luna Women'S Wellness and Birth Center PC

Primary specialty

Birthing Clinic/CenterTaxonomy code 261QB0400X

License

32831 Issued in MN

Legal business name

LUNA WOMEN'S WELLNESS AND BIRTH CENTER PC

Practice address

117 Gillis Ave NE
Brainerd, MN 56401-3131

Phone

(218) 828-7773

Fax

(218) 828-2976

NPI assigned

Oct 25, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nicolle Marie Uban, PHD, APRN, CNM

Title

Owner/Midwife Director

Phone

(218) 828-7773

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1093267189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 GILLIS AVE NE",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "56401",
            "telephone_number": "218-828-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 GILLIS AVE NE",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013131",
            "telephone_number": "218-828-7773",
            "fax_number": "218-828-2976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 Gillis Ave NE",
            "address_purpose": "LOCATION",
            "city": "Brainerd",
            "state": "MN",
            "postal_code": "56104",
            "country_code": "US",
            "telephone_number": "218-828-7773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUNA WOMEN'S WELLNESS AND BIRTH CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "UBAN",
        "authorized_official_first_name": "NICOLLE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/MIDWIFE DIRECTOR",
        "authorized_official_telephone_number": "218-828-7773",
        "authorized_official_credential": "PHD, APRN, CNM"
    },
    "taxonomies": [
        {
            "code": "261QB0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Birthing",
            "state": "MN",
            "license": "32831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1902103658",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Live Well Chiropractic
• Suzanne Marie Lokken
• Pauline Ann Long, RN
• Alicia R Lorensen, APRN,CNP
• Chenise R Lozancic, PHARMD
• Luna Women'S Wellness and Birth Center PC
• Paul Richard Lund, MD
• Sarah Lundy, DPT
• Lyle Maciver
• Roger Macy, MD

• Birthing Clinic/Center in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Birthing Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.