Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 365 | CA |
NPI | 1013351196 |
---|---|
Provider Name | Krystel V Cunningfolk |
First Address | Sacramento, CA 95819-3441 |
Second Address | Sacramento, CA 95819-3441 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2013 |
Last Update Date | 09/05/2019 |