Healthcare Provider Details

I. General information

NPI: 1134538341
Provider Name (Legal Business Name): WHITNEY FIELDS MIRVIS RN, MSN,CNM, IBCIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WHITNEY LENGER MIRVIS RN, MSN,CNM, IBCLC

II. Dates (important events)

Enumeration Date: 08/13/2014
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 OLENTANGY RIVER RD 1ST FLOOR YELLOW
COLUMBUS OH
43214-3908
US

IV. Provider business mailing address

3535 OLENTANGY RIVER RD WOMEN'S CENTER
COLUMBUS OH
43214-3908
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-5094
  • Fax: 614-566-5094
Mailing address:
  • Phone: 614-566-5094
  • Fax: 614-566-1869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberCOA 17730-NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCOA 17732-NM
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN 142265
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: