Healthcare Provider Details

I. General information

NPI: 1720021215
Provider Name (Legal Business Name): JENNIFER Y FIELDS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 11/08/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHINLE SERVICE UNIT IHS HIGHWAY 191 AND HOSPITAL ROAD
CHINLE AZ
86503
US

IV. Provider business mailing address

PO BOX PH
CHINLE AZ
86503-8000
US

V. Phone/Fax

Practice location:
  • Phone: 928-674-7043
  • Fax:
Mailing address:
  • Phone: 928-674-7001
  • Fax: 303-320-2947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number124408
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number200050096NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: