Healthcare Provider Details

I. General information

NPI: 1083247159
Provider Name (Legal Business Name): ALINA JAWARD CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2020
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 COLE RD
MONROE MI
48162-4103
US

IV. Provider business mailing address

55 COLE RD
MONROE MI
48162-4103
US

V. Phone/Fax

Practice location:
  • Phone: 734-347-3027
  • Fax:
Mailing address:
  • Phone: 419-255-1020
  • Fax: 419-259-6001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number4704319038
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: