Healthcare Provider Details

I. General information

NPI: 1437133642
Provider Name (Legal Business Name): BARBARA NOVAK CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 W COMMERCE CT
TUCSON AZ
85746-6015
US

IV. Provider business mailing address

1500 W COMMERCE CT
TUCSON AZ
85746-6015
US

V. Phone/Fax

Practice location:
  • Phone: 520-670-3909
  • Fax: 520-806-2625
Mailing address:
  • Phone: 520-670-3909
  • Fax: 520-806-2625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberRN037388
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: