Healthcare Provider Details

I. General information

NPI: 1487385712
Provider Name (Legal Business Name): MARIE ROSE BIRD DNP, CNM, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2022
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 W FRYE RD BLDG B
CHANDLER AZ
85224-6255
US

IV. Provider business mailing address

1950 W FRYE RD BLDG B
CHANDLER AZ
85224-6255
US

V. Phone/Fax

Practice location:
  • Phone: 480-895-9555
  • Fax:
Mailing address:
  • Phone: 480-895-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number12076791-3102
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number12076791-4402
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number321225
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: