# MARY BETH CANAVAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1326148677
- **Gender:** F
- **Credential:** CNM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 367A00000X | Advanced Practice Midwife | NMW1440 | CA | Yes |

## Other

- **Enumeration date:** 09/25/2006
- **Last updated:** 08/03/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 05-1822 | FQHC MEDICARE PART A | CA |
| 05 | — | FHC11991F | — | CA |
| 01 | — | HAP11991F | FPACT | CA |
| 01 | — | ZZZ79046Z | FQHC MEDICARE PART B | CA |