Healthcare Provider Details

I. General information

NPI: 1346556651
Provider Name (Legal Business Name): MARGARET JOANNE CANADAY L.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2010
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 E LAS PALMARITAS DR
PHOENIX AZ
85020-3738
US

IV. Provider business mailing address

1042 E LAS PALMARITAS DR
PHOENIX AZ
85020-3738
US

V. Phone/Fax

Practice location:
  • Phone: 602-400-0697
  • Fax:
Mailing address:
  • Phone: 602-400-0697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number0160
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: