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General NPI Number Information
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NPI Number | 1053123539
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Entity Type | Individual
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Provider Name | JILLIAN SARAH MICHALENKO CNM
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Gender | Female
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 9475 BRIAR VILLAGE PT STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7902
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Country | US
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Telephone | 719-367-9405
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Fax |
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Provider Business Mailing Address
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Address Line | 2 MARSHALL RD
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City | PITTSBURGH
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State | PA
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Zip | 15214-2602
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Country | US
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Telephone | 724-809-5246
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | MW010847
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License Number State | PA
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