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General NPI Number Information
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NPI Number | 1346655446
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Entity Type | Organization
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Legal Business Name | ARIZONA MIDWIFE LLC
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 06/26/2014
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Provider Practice Location Address
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Address Line | 12790 W LUNDBERG ST
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City | SURPRISE
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State | AZ
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Zip | 85378-3728
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Country | US
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Telephone | 602-643-9433
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Fax | 480-247-4344
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Provider Business Mailing Address
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Address Line | 8485 E MCDONALD DR # 500
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-6335
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Country | US
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Telephone | 602-643-9433
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Fax | 480-247-4344
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Authorized Official
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Title or Position | MIDWIFE
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Name | MRS. ALICIA L WITT
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Credential | LM, CPM
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Telephone | 801-759-5124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | LM180
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License Number State | AZ
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