Healthcare Provider Details

I. General information

NPI: 1497091094
Provider Name (Legal Business Name): TIGERLILY WOMEN'S HEALTH & MIDWIFERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2012
Last Update Date: 05/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15B VIA CONTENTA
CARMEL VALLEY CA
93924
US

IV. Provider business mailing address

15B VIA CONTENTA
CARMEL VALLEY CA
93924
US

V. Phone/Fax

Practice location:
  • Phone: 831-238-6280
  • Fax: 831-886-1634
Mailing address:
  • Phone: 831-238-6280
  • Fax: 831-886-1634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1901
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1901
License Number StateCA

VIII. Authorized Official

Name: JAMIE MEYERHOFF
Title or Position: CLINICIAN/CONTACT
Credential: CNM
Phone: 831-238-6280