Provider Demographics
NPI:1578822045
Name:WOMANCARE, LLC
Entity type:Organization
Organization Name:WOMANCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNM/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEANN
Authorized Official - Middle Name:VAN DEN
Authorized Official - Last Name:VAN DEN BOSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-450-3422
Mailing Address - Street 1:216 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-5568
Mailing Address - Country:US
Mailing Address - Phone:507-450-3422
Mailing Address - Fax:
Practice Address - Street 1:51 E 4TH ST
Practice Address - Street 2:SUITE 405
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-3507
Practice Address - Country:US
Practice Address - Phone:507-450-3422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1302053367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty