Healthcare Provider Details

I. General information

NPI: 1376726984
Provider Name (Legal Business Name): LESHINE C. HERFINDAHL CDM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 DANISH CIRCLE
GIRDWOOD AK
99587
US

IV. Provider business mailing address

12740 SILVER SPRUCE DR
ANCHORAGE AK
99516-2692
US

V. Phone/Fax

Practice location:
  • Phone: 907-783-2931
  • Fax:
Mailing address:
  • Phone: 907-227-3165
  • Fax: 907-349-3056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License NumberAA6
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: