Healthcare Provider Details

I. General information

NPI: 1346599297
Provider Name (Legal Business Name): DEBORAH MARIE HERVEY LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2012
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 W LOUGHLIN DR
CHANDLER AZ
85225-2146
US

IV. Provider business mailing address

713 W LOUGHLIN DR
CHANDLER AZ
85225-2146
US

V. Phone/Fax

Practice location:
  • Phone: 480-206-5578
  • Fax:
Mailing address:
  • Phone: 480-206-5578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM165
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: