Provider Demographics
NPI:1497091094
Name:TIGERLILY WOMEN'S HEALTH & MIDWIFERY
Entity Type:Organization
Organization Name:TIGERLILY WOMEN'S HEALTH & MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/CONTACT
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYERHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:831-238-6280
Mailing Address - Street 1:15B VIA CONTENTA
Mailing Address - Street 2:
Mailing Address - City:CARMEL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93924
Mailing Address - Country:US
Mailing Address - Phone:831-238-6280
Mailing Address - Fax:831-886-1634
Practice Address - Street 1:15B VIA CONTENTA
Practice Address - Street 2:
Practice Address - City:CARMEL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93924
Practice Address - Country:US
Practice Address - Phone:831-238-6280
Practice Address - Fax:831-886-1634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1901363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1901OtherCALIFORNIA BRN