Individual
MRS. JOANN SMITH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM, ARNP
Contact information
Practice address
91275 66TH AVE, SUITE 500, MECCA, CA 92254-6515
(760) 396-1249
(760) 396-1253
Mailing address
PO BOX 1378, MECCA, CA 92254-1378
(760) 396-1249
(760) 396-1253
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
1435
MD
367A00000X
Advanced Practice Midwife
Primary
235806
CA
367A00000X
Advanced Practice Midwife
RN122050
GA
Other
Enumeration date
05/22/2013
Last updated
07/02/2020
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