Healthcare Provider Details

I. General information

NPI: 1891865481
Provider Name (Legal Business Name): PAMELA STUART CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 SISTER MARY COLUMBA DR
RED BLUFF CA
96080-4356
US

IV. Provider business mailing address

3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US

V. Phone/Fax

Practice location:
  • Phone: 530-528-6170
  • Fax: 530-528-6192
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberRN488887
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: