Healthcare Provider Details

I. General information

NPI: 1164663902
Provider Name (Legal Business Name): MICHELLE LONGA KARPIN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2009
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 CASA ST STE 220
SAN LUIS OBISPO CA
93405-1890
US

IV. Provider business mailing address

1030 SOUTHWOOD DR
SAN LUIS OBISPO CA
93401-5813
US

V. Phone/Fax

Practice location:
  • Phone: 805-595-1808
  • Fax: 805-595-1815
Mailing address:
  • Phone: 805-544-4355
  • Fax: 805-549-8388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: