Healthcare Provider Details

I. General information

NPI: 1326195660
Provider Name (Legal Business Name): SUZANNE LYNN SAUNDERS CNM, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 02/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 DOYLE PARK DR STE 103
SANTA ROSA CA
95405-4559
US

IV. Provider business mailing address

3536 MENDOCINO AVE STE 200
SANTA ROSA CA
95403-3634
US

V. Phone/Fax

Practice location:
  • Phone: 707-579-1102
  • Fax: 707-579-1386
Mailing address:
  • Phone: 707-579-1102
  • Fax: 707-579-1386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNMW1414
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: