Healthcare Provider Details

I. General information

NPI: 1982287066
Provider Name (Legal Business Name): AMANDA MARIE RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9930 W INDIAN SCHOOL RD
PHOENIX AZ
85037-5902
US

IV. Provider business mailing address

10401 W MISSOURI AVE
GLENDALE AZ
85307-4306
US

V. Phone/Fax

Practice location:
  • Phone: 623-846-7558
  • Fax:
Mailing address:
  • Phone: 623-451-0119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number250286
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number250286
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: