Provider Demographics
NPI:1609332576
Name:DESROCHERS, MEGAN E (CPM LM)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:E
Last Name:DESROCHERS
Suffix:
Gender:F
Credentials:CPM LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19580 W INDIAN SCHOOL RD # 105-145
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-2081
Mailing Address - Country:US
Mailing Address - Phone:480-608-3444
Mailing Address - Fax:480-573-2172
Practice Address - Street 1:19580 W INDIAN SCHOOL RD # 105-145
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-2081
Practice Address - Country:US
Practice Address - Phone:480-608-3444
Practice Address - Fax:480-573-2172
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99349176B00000X
AZLM274176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife