Provider Demographics
NPI:1932277365
Name:MIELKE, RUTH TURNQUIST (CNM, MS)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:TURNQUIST
Last Name:MIELKE
Suffix:
Gender:F
Credentials:CNM, MS
Other - Prefix:MS
Other - First Name:RUTH
Other - Middle Name:ELLEN
Other - Last Name:TURNQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RUTH MIELKE
Mailing Address - Street 1:1705 LOMA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-3903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:323 N PRAIRIE AVE
Practice Address - Street 2:#210
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4502
Practice Address - Country:US
Practice Address - Phone:310-673-2647
Practice Address - Fax:310-673-2657
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA579367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife