Shauna Kenealey, LM, CPM, IBCLC

Individual provider Active NPI Midwife · Comptche, CA

NPI 1992948715 · NPPES record last updated Mar 10, 2023

Key facts

NPI
1992948715
Entity type
Individual (NPI type 1)
Primary specialty
Midwife 176B00000X
License
LM399 (CA)
Practice address
26020 Comptche-Ukiah Rd
Comptche, CA 95427
Phone
(541) 727-1907
Fax
(541) 256-3772
NPI assigned
Apr 9, 2009
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

LicenseStateTypeSpecialty
LM399CAMDMidwife

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X L-22176
Midwife 176B00000X LM399 CA Yes

Addresses

Primary practice location

26020 Comptche-Ukiah Rd
Comptche, CA 95427

Mailing address

PO Box 165
Comptche, CA 95427
Phone (541) 727-1907

Other providers in Comptche, CA

All providers in Comptche, CA · Midwife in California

Sources for this page

Verify at the official NPI Registry.