Healthcare Provider Details

I. General information

NPI: 1437709854
Provider Name (Legal Business Name): TINA MARIE EGNER APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2019
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71777 SAN JACINTO DR STE 202
RANCHO MIRAGE CA
92270-4457
US

IV. Provider business mailing address

1075 CAMINO DEL RIO S
SAN DIEGO CA
92108-3538
US

V. Phone/Fax

Practice location:
  • Phone: 888-743-7526
  • Fax:
Mailing address:
  • Phone: 888-743-7526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNMW236129
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM406
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: