Healthcare Provider Details

I. General information

NPI: 1881476604
Provider Name (Legal Business Name): SOPHIA NAMAZZI CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E 9TH ST
IOWA CITY IA
52241-2209
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-2294
  • Fax: 319-467-2510
Mailing address:
  • Phone: 319-356-2294
  • Fax: 319-467-2510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number4704358258
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberB177112
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: