Healthcare Provider Details

I. General information

NPI: 1801160395
Provider Name (Legal Business Name): AMY VAUGHN CEFALO LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2012
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19801 JONES RD
LITTLE ROCK AR
72206-9088
US

IV. Provider business mailing address

PO BOX 250937
LITTLE ROCK AR
72225-0937
US

V. Phone/Fax

Practice location:
  • Phone: 501-590-6285
  • Fax:
Mailing address:
  • Phone: 501-590-6285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: