Healthcare Provider Details

I. General information

NPI: 1639749252
Provider Name (Legal Business Name): CARIE LYNN COMSTOCK CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2021
Last Update Date: 06/26/2021
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 E 500 S
CLEARFIELD UT
84015-1088
US

IV. Provider business mailing address

354 E 500 S
CLEARFIELD UT
84015-1088
US

V. Phone/Fax

Practice location:
  • Phone: 801-836-6673
  • Fax:
Mailing address:
  • Phone: 801-836-6673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: