Healthcare Provider Details

I. General information

NPI: 1306701412
Provider Name (Legal Business Name): MARIAH KAY MCDOWELL TM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 5TH ST E
SAINT PAUL MN
55106-5316
US

IV. Provider business mailing address

1219 5TH ST E
SAINT PAUL MN
55106-5316
US

V. Phone/Fax

Practice location:
  • Phone: 952-215-4041
  • Fax: 612-255-4807
Mailing address:
  • Phone: 952-215-4041
  • Fax: 612-255-4807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: