Healthcare Provider Details

I. General information

NPI: 1083268114
Provider Name (Legal Business Name): RACHEL J WALSH CPM, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2019
Last Update Date: 07/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 N PASEO SONOYTA
TUCSON AZ
85750-1619
US

IV. Provider business mailing address

4801 N PASEO SONOYTA
TUCSON AZ
85750-1619
US

V. Phone/Fax

Practice location:
  • Phone: 310-913-3176
  • Fax:
Mailing address:
  • Phone: 310-913-3176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM224
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: