Healthcare Provider Details

I. General information

NPI: 1376588111
Provider Name (Legal Business Name): YVONNE L. FENRICH WHCNP, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 07/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229, 1890 WAITE ST #1
NORTH BEND OR
97459
US

IV. Provider business mailing address

705 ELM ST SW
ALBANY OR
97321-1956
US

V. Phone/Fax

Practice location:
  • Phone: 541-756-6232
  • Fax:
Mailing address:
  • Phone: 541-812-4850
  • Fax: 541-812-4889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number093000329N5/RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: