Provider Demographics
NPI:1346655446
Name:ARIZONA MIDWIFE LLC
Entity Type:Organization
Organization Name:ARIZONA MIDWIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WITT
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:801-759-5124
Mailing Address - Street 1:8485 E MCDONALD DR # 500
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-6335
Mailing Address - Country:US
Mailing Address - Phone:602-643-9433
Mailing Address - Fax:480-247-4344
Practice Address - Street 1:12790 W LUNDBERG ST
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-3728
Practice Address - Country:US
Practice Address - Phone:602-643-9433
Practice Address - Fax:480-247-4344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLM180176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty