Healthcare Provider Details

I. General information

NPI: 1972653509
Provider Name (Legal Business Name): CATHLEEN JOY CAGLE BROWN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOY BROWN CNM

II. Dates (important events)

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

III. Provider practice location address

1122 S ST SUITE 102
FRESNO CA
93721-1430
US

IV. Provider business mailing address

5307 N MILLBROOK AVE
FRESNO CA
93710-7315
US

V. Phone/Fax

Practice location:
  • Phone: 559-495-3120
  • Fax:
Mailing address:
  • Phone: 559-760-1826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1434
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: