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General NPI Number Information
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NPI Number | 1003611344
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Entity Type | Individual
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Provider Name | PAULA LYNN HERTZ CNM
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Gender | Female
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 301 MADISON ST STE 120
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City | JOLIET
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State | IL
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Zip | 60435-6652
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Country | US
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Telephone | 815-725-2699
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Fax |
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Provider Business Mailing Address
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Address Line | 555 W COURT ST STE 406
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City | KANKAKEE
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State | IL
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Zip | 60901-3675
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Country | US
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Telephone | 815-932-7474
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 209031820
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 209.031820
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License Number State | IL
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