Provider Demographics
NPI:1235419359
Name:FALCON, JOANN (CPM)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:
Last Name:FALCON
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 WINDSOR AVE LOT 31
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-9582
Mailing Address - Country:US
Mailing Address - Phone:618-292-4732
Mailing Address - Fax:
Practice Address - Street 1:178 WINDSOR AVE LOT 31
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-9582
Practice Address - Country:US
Practice Address - Phone:618-292-4732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-20
Last Update Date:2011-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO10090012176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife