Provider Demographics
NPI:1871145425
Name:MADELEINE SHERNOCK CORP.
Entity type:Organization
Organization Name:MADELEINE SHERNOCK CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:MADELEINE
Authorized Official - Middle Name:JUSTINE
Authorized Official - Last Name:WISNER
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:916-668-9467
Mailing Address - Street 1:4500 47TH AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95824-3848
Mailing Address - Country:US
Mailing Address - Phone:916-668-9467
Mailing Address - Fax:209-336-6814
Practice Address - Street 1:4500 47TH AVE STE 5
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95824-3848
Practice Address - Country:US
Practice Address - Phone:916-668-9467
Practice Address - Fax:209-336-6814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-14
Last Update Date:2020-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty