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General NPI Number Information
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NPI Number | 1861706087
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Entity Type | Organization
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Legal Business Name | WHBC MIDWIVES, INC., A NURSING CORPORATION
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 07/29/2010
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Provider Practice Location Address
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Address Line | 583 SUMMERFIELD RD
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City | SANTA ROSA
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State | CA
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Zip | 95405-5239
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Country | US
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Telephone | 707-539-1544
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Fax |
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Provider Business Mailing Address
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Address Line | 583 SUMMERFIELD RD
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City | SANTA ROSA
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State | CA
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Zip | 95405-5239
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Country | US
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Telephone | 707-539-1544
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER ELAINE NYDAM
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Credential | R.N., C.N.M.
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Telephone | 707-539-1544
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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 | 3306897
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License Number State | CA
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