Basic Information
| Provider Information | |||||||||
| NPI: | 1689647729 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAUER | ||||||||
| FirstName: | MARLA | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 TRANCAS ST 300 | ||||||||
| Address2: | |||||||||
| City: | NAPA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945582921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074929236 | ||||||||
| FaxNumber: | 4259495377 | ||||||||
| Practice Location | |||||||||
| Address1: | 1141 PEAR TREE LN | ||||||||
| Address2: | |||||||||
| City: | NAPA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072541774 | ||||||||
| FaxNumber: | 7072512993 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2006 | ||||||||
| LastUpdateDate: | 09/28/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | RN966363 | DC | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 367A00000X | 1926 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 374700000X | NMW 1926 | CA | N | Nursing Service Related Providers | Technician |
ID Information
| ID | Type | State | Issuer | Description | 007794614 | 05 | DC | MEDICAID | 034579200 | 05 | DC | MEDICAID | 400937100 | 05 | DC | MEDICAID |