Healthcare Provider Details

I. General information

NPI: 1407409782
Provider Name (Legal Business Name): DESIREE ANDREA ARIAS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 07/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14239 W BELL RD STE 210
SURPRISE AZ
85374-2471
US

IV. Provider business mailing address

15296 W REDFIELD RD
SURPRISE AZ
85379-8018
US

V. Phone/Fax

Practice location:
  • Phone: 623-584-0800
  • Fax: 623-584-0312
Mailing address:
  • Phone: 623-466-4335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number228588
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: