Shelagh Carrick, LM
Individual provider Active NPI Midwife · Crescent City, CA
NPI 1609137181 · NPPES record last updated May 31, 2012
Key facts
- NPI
- 1609137181
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Midwife 176B00000X
- License
- CALM111 (CA)
- Practice address
- 2610 Roy Ave
Crescent City, CA 95531-9101 - Phone
- (707) 464-9664
- NPI assigned
- May 31, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CALM111 | CA | MD | Midwife |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | CALM111 | CA | Yes |
Addresses
Primary practice location
2610 Roy Ave
Crescent City, CA 95531-9101
Mailing address
2610 Roy Ave
Crescent City, CA 95531-9101
Phone (707) 464-9664
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CALM111 | Other | CA | CALIFORNIA MEDICAL BOARD |
Other providers in Crescent City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2012. 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.