Provider Demographics
NPI:1740685122
Name:CHIWAULA, JOANNE JORISSEN (CNM)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:JORISSEN
Last Name:CHIWAULA
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:PEOPLE'S COMMUNITY CLINIC
Mailing Address - Street 2:2909 N I-35
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78722
Mailing Address - Country:US
Mailing Address - Phone:512-478-4939
Mailing Address - Fax:
Practice Address - Street 1:PEOPLE'S COMMUNITY CLINIC
Practice Address - Street 2:2909 N I-35
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78722
Practice Address - Country:US
Practice Address - Phone:512-478-4939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-28
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX754366163W00000X
TXAP126622163WM0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn