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NPI Code Detail

MEDICARE: MS. ELIZABETH POINTER SMITH CNM

MEDICARE: MS. ELIZABETH POINTER SMITH CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice MidwifeNMW1382CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NMW1382OTHERCACERTIFIED NURSE MIDWIFE LICENSE

General Provider Information

NPI Number : 1497016711
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH POINTER SMITH CNM
Provider Business Mailing Address
First Line : 1565 BRIARFIELD PL
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-2055
Country : US
Telephone Number : 707-538-9349
Fax Number :
Provider Business Practice Location Address
First Line : 4415 SONOMA HWY STE B
Second Line :
City : SANTA ROSA
State : CA
Zip : 95409-4165
Country : US
Telephone Number : 707-539-1544
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2012
Last Update Date : 12/04/2023

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