MEDICARE: MARINDA SHINDLER CPM, LM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	0129-000141	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0129-000141	OTHER	VA	LICENSE

General Provider Information

NPI Number	:	1568921666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARINDA SHINDLER CPM, LM

Provider Business Mailing Address
First Line	:	6219 LAKESIDE AVE
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23228-5238
Country	:	US
Telephone Number	:	804-601-6992
Fax Number	:	888-208-8058

Provider Business Practice Location Address
First Line	:	6219 LAKESIDE AVE
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23228-5238
Country	:	US
Telephone Number	:	804-601-6992
Fax Number	:	888-208-8058

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2019
Last Update Date	:	03/18/2019

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