Healthcare Provider Details

I. General information

NPI: 1366756587
Provider Name (Legal Business Name): IFEYINWA OBI CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 10TH ST
ARCATA CA
95521-6210
US

IV. Provider business mailing address

1275 8TH ST
ARCATA CA
95521-5770
US

V. Phone/Fax

Practice location:
  • Phone: 707-630-5177
  • Fax: 707-237-0426
Mailing address:
  • Phone: 707-826-8633
  • Fax: 707-826-8638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: