Provider Demographics
NPI:1386032852
Name:SOUTHERN ARIZONA MIDWIVES
Entity Type:Organization
Organization Name:SOUTHERN ARIZONA MIDWIVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSE MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GARATE
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:520-227-0277
Mailing Address - Street 1:1296 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-1396
Mailing Address - Country:US
Mailing Address - Phone:520-227-0277
Mailing Address - Fax:
Practice Address - Street 1:4677 NORTH COMMERCE DR
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635
Practice Address - Country:US
Practice Address - Phone:520-439-2139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP7542367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty