Healthcare Provider Details

I. General information

NPI: 1043487952
Provider Name (Legal Business Name): KAREN SUE MASCHUE LPN, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 05/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7353 N 41ST AVE
PHOENIX AZ
85051-8160
US

IV. Provider business mailing address

7353 N 41ST AVE
PHOENIX AZ
85051
US

V. Phone/Fax

Practice location:
  • Phone: 602-487-0504
  • Fax: 623-792-8187
Mailing address:
  • Phone: 602-487-0504
  • Fax: 623-792-8187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM137
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: