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General NPI Number Information
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NPI Number | 1942012026
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Entity Type | Individual
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Provider Name | NICOLE JULIANA DU MAINE CNM
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Gender | Female
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 2020 SUTTER PL STE 203
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City | DAVIS
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State | CA
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Zip | 95616-6217
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Country | US
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Telephone | 530-750-5880
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 255228
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City | SACRAMENTO
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State | CA
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Zip | 95865-5228
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Country | US
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Telephone | 800-470-0071
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 95031425
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License Number State | CA
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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 | 236480
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License Number State | CA
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