Provider Demographics
NPI:1841181591
Name:DIVINELY DESIGNED MIDWIFERY, LLC
Entity type:Organization
Organization Name:DIVINELY DESIGNED MIDWIFERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PROFESSIONAL MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:KELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTTS
Authorized Official - Suffix:
Authorized Official - Credentials:CPM
Authorized Official - Phone:865-214-7311
Mailing Address - Street 1:PO BOX 88
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-0088
Mailing Address - Country:US
Mailing Address - Phone:865-214-7311
Mailing Address - Fax:
Practice Address - Street 1:3239 SHROPSHIRE BLVD UNIT 88
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-8405
Practice Address - Country:US
Practice Address - Phone:865-214-7311
Practice Address - Fax:865-378-5026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty