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Individual

MRS. MARYAM MODIRROUSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM, NP

Contact information

Practice address
18300 US HIGHWAY 18, APPLE VALLEY, CA 92307-2206
(706) 242-2311
(760) 946-8875
Mailing address
18300 US HIGHWAY 18, APPLE VALLEY, CA 92307-2206
(706) 242-2311
(760) 946-8875

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
NMW1949
CA

Other

Enumeration date
10/29/2012
Last updated
12/08/2021
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