NPI Number: 1134538341
Health Care Provider/Practitioner: WHITNEY FIELDS MIRVIS RN, MSN,CNM, IBCIC
Information about “1134538341” NPI (WHITNEY FIELDS MIRVIS RN, MSN,CNM, IBCIC)
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<NPI>
1134538341
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Individual
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N
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MIRVIS
</LastName>
<FirstName>
WHITNEY
</FirstName>
<MiddleName>
FIELDS
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<NamePrefix/>
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<Credential>
RN, MSN,CNM, IBCIC
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MIRVIS
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WHITNEY
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LENGER
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<OtherCredential>
RN, MSN,CNM, IBCLC
</OtherCredential>
<OtherLastNameTypeCode>
2
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<FirstLineMailingAddress>
3535 OLENTANGY RIVER RD
</FirstLineMailingAddress>
<SecondLineMailingAddress>
WOMEN'S CENTER
</SecondLineMailingAddress>
<MailingAddressCityName>
COLUMBUS
</MailingAddressCityName>
<MailingAddressStateName>
OH
</MailingAddressStateName>
<MailingAddressPostalCode>
43214-3908
</MailingAddressPostalCode>
<MailingAddressCountryCode>
US
</MailingAddressCountryCode>
<MailingAddressTelephoneNumber>
614-566-5094
</MailingAddressTelephoneNumber>
<MailingAddressFaxNumber>
614-566-1869
</MailingAddressFaxNumber>
<FirstLinePracticeLocationAddress>
3535 OLENTANGY RIVER RD
</FirstLinePracticeLocationAddress>
<SecondLinePracticeLocationAddress>
1ST FLOOR YELLOW
</SecondLinePracticeLocationAddress>
<PracticeLocationAddressCityName>
COLUMBUS
</PracticeLocationAddressCityName>
<PracticeLocationAddressStateName>
OH
</PracticeLocationAddressStateName>
<PracticeLocationAddressPostalCode>
43214-3908
</PracticeLocationAddressPostalCode>
<PracticeLocationAddressCountryCode>
US
</PracticeLocationAddressCountryCode>
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614-566-5094
</PracticeLocationAddressTelephoneNumber>
<PracticeLocationAddressFaxNumber>
614-566-5094
</PracticeLocationAddressFaxNumber>
<EnumerationDate>
08/13/2014
</EnumerationDate>
<LastUpdateDate>
09/08/2015
</LastUpdateDate>
<NPIDeactivationReasonCode/>
<NPIDeactivationReason/>
<NPIDeactivationDate/>
<NPIReactivationDate/>
<GenderCode>
F
</GenderCode>
<Gender>
Female
</Gender>
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<AuthorizedOfficialCredential/>
<AuthorizedOfficialTelephoneNumber/>
<Taxonomies>
<Taxonomy>
<TaxonomyCode>
163WL0100X
</TaxonomyCode>
<TaxonomyName>
Lactation Consultant (Registered Nurse)
</TaxonomyName>
<LicenseNumber>
RN 142265
</LicenseNumber>
<LicenseNumberStateCode>
OH
</LicenseNumberStateCode>
<PrimaryTaxonomySwitch>
N
</PrimaryTaxonomySwitch>
</Taxonomy>
<Taxonomy>
<TaxonomyCode>
363LW0102X
</TaxonomyCode>
<TaxonomyName>
Women's Health Nurse Practitioner
</TaxonomyName>
<LicenseNumber>
COA 17730-NP
</LicenseNumber>
<LicenseNumberStateCode>
OH
</LicenseNumberStateCode>
<PrimaryTaxonomySwitch>
N
</PrimaryTaxonomySwitch>
</Taxonomy>
<Taxonomy>
<TaxonomyCode>
367A00000X
</TaxonomyCode>
<TaxonomyName>
Advanced Practice Midwife
</TaxonomyName>
<LicenseNumber>
COA 17732-NM
</LicenseNumber>
<LicenseNumberStateCode>
OH
</LicenseNumberStateCode>
<PrimaryTaxonomySwitch>
Y
</PrimaryTaxonomySwitch>
</Taxonomy>
</Taxonomies>
<HealthcareProviderTaxonomyGroups/>
</Npi>
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