La Neice Lorraine Abdel-Shakur, CNM
Individual provider Active NPI Advanced Practice Midwife · Travis Afb, CA
NPI 1215098512 · NPPES record last updated Nov 3, 2014
Key facts
- NPI
- 1215098512
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Advanced Practice Midwife 367A00000X
- License
- 1906 (CA)
- Practice address
- 101 Bodin Cir
David Grant Medical Center
Travis Afb, CA 94535-1809 - Phone
- (707) 423-5406
- Fax
- (707) 423-7356
- NPI assigned
- Dec 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 704600 | CA | MD | Inpatient Obstetric Registered Nurse |
| 1906 | CA | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Inpatient Obstetric Registered Nurse | 163WX0003X | 704600 | CA | |
| Advanced Practice Midwife | 367A00000X | 1906 | CA | Yes |
Addresses
Primary practice location
101 Bodin Cir
David Grant Medical Center
Travis Afb, CA 94535-1809
Mailing address
101 Bodin Cir
Women'S Health
Travis Afb, CA 94535-1809
Phone (707) 423-5406
Other names
- Miss La Neice Lorraine Perkins
Other providers in Travis Afb, CA
- 60 MSGS
- 60TH Medgrp-Travis
- 60TH Medgrp-Travis
- 60TH Medical Group
- Nataliya Alexandrovna Ables
- Eric Louis Abram
- Kristy Abrams
- Javier A Abreu
- Nicholas Adams
All providers in Travis Afb, CA · Advanced Practice Midwife in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.