Individual
MISTY PHOMMATHETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CNM, WHNP-BC
Contact information
Practice address
2767 OLIVE HWY, OROVILLE, CA 95966-6118
(530) 533-8500
Mailing address
8816 WATERVIEW RD, MACHESNEY PARK, IL 61115-2035
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
236351
CA
Other
Enumeration date
12/19/2022
Last updated
06/27/2025
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