Healthcare Provider Details

I. General information

NPI: 1023851995
Provider Name (Legal Business Name): MEGAN ROSE FRANK CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN ROSE HERRLE

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 RENZ LN
GILROY CA
95020-9584
US

IV. Provider business mailing address

10055 CARMEN RD
CUPERTINO CA
95014-1046
US

V. Phone/Fax

Practice location:
  • Phone: 408-847-1739
  • Fax:
Mailing address:
  • Phone: 504-940-7340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236436
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: