Provider Demographics
NPI:1740584549
Name:HUMBOLDT WOMENS HEALTH INC
Entity Type:Organization
Organization Name:HUMBOLDT WOMENS HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:NEVIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-945-4030
Mailing Address - Street 1:3798 JANES RD STE 10
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-4745
Mailing Address - Country:US
Mailing Address - Phone:707-825-0200
Mailing Address - Fax:707-825-0202
Practice Address - Street 1:3798 JANES RD STE 10
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-4745
Practice Address - Country:US
Practice Address - Phone:707-825-0200
Practice Address - Fax:707-825-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-07
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC53962207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty