Healthcare Provider Details

I. General information

NPI: 1740653393
Provider Name (Legal Business Name): VICTORIA ROSE SMET CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA ROSE MAYFIELD

II. Dates (important events)

Enumeration Date: 11/04/2015
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 ROYAL AVE UNIT 350
MEDFORD OR
97504-6194
US

IV. Provider business mailing address

PO BOX 31001
PASADENA CA
91110-4180
US

V. Phone/Fax

Practice location:
  • Phone: 541-732-7460
  • Fax:
Mailing address:
  • Phone: 541-732-7460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number201508265NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: