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General NPI Number Information
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NPI Number | 1790814143
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Entity Type | Individual
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Provider Name | CARRIE REEDTZ SPARREVOHN LM
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Gender | Female
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Dates
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Enumeration Date | 03/03/2007
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Last Update Date | 03/09/2016
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Provider Practice Location Address
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Address Line | 10950 BACHELOR VALLEY RD
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City | WITTER SPRINGS
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State | CA
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Zip | 95493-9734
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Country | US
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Telephone | 530-304-3417
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Fax |
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Provider Business Mailing Address
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Address Line | 10950 BACHELOR VALLEY RD
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City | WITTER SPRINGS
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State | CA
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Zip | 95493-9734
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Country | US
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Telephone | 530-304-3417
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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 | LM25
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License Number State | CA
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