Provider Demographics
NPI:1417965153
Name:YUNCK, LOUISE A (CNM)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:A
Last Name:YUNCK
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20800 CENTER RIDGE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-4312
Mailing Address - Country:US
Mailing Address - Phone:440-333-1020
Mailing Address - Fax:440-331-4245
Practice Address - Street 1:20800 CENTER RIDGE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-4312
Practice Address - Country:US
Practice Address - Phone:440-333-1020
Practice Address - Fax:440-331-4245
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN248501176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2165366Medicaid
OHNM02606Medicare PIN