Individual
MS. MARY J ENDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
2955 IVY RD STE 304, CHARLOTTESVILLE, VA 22903-9353
(434) 243-4570
(434) 295-5491
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0024173448
VA
367A00000X
Advanced Practice Midwife
Primary
0024173448
VA
367A00000X
Advanced Practice Midwife
AP60753690
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2081868
—
WA
Enumeration date
03/17/2016
Last updated
02/05/2024
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