Healthcare Provider Details

I. General information

NPI: 1598062903
Provider Name (Legal Business Name): LAURA MARIE CORREIA CPM, LM, CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2011
Last Update Date: 06/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2133 W SHARON AVE
PHOENIX AZ
85029-1529
US

IV. Provider business mailing address

2133 W SHARON AVE
PHOENIX AZ
85029-1529
US

V. Phone/Fax

Practice location:
  • Phone: 480-442-2294
  • Fax: 866-442-2294
Mailing address:
  • Phone: 480-442-2294
  • Fax: 866-442-2294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM198
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: