Provider Demographics
NPI:1316005697
Name:MIELKE, RUTH K (CNM)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:K
Last Name:MIELKE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:RUTH
Other - Middle Name:K
Other - Last Name:FARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:38 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-1134
Mailing Address - Country:US
Mailing Address - Phone:916-601-2750
Mailing Address - Fax:
Practice Address - Street 1:27 PARK ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-771-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1524367A00000X
MA367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife