Provider Demographics
NPI:1851414742
Name:SAGE MIDWIFERY, INC.
Entity Type:Organization
Organization Name:SAGE MIDWIFERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARINAH
Authorized Official - Middle Name:VALENZUELA
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:602-793-5063
Mailing Address - Street 1:1537 W TUCKEY LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1451
Mailing Address - Country:US
Mailing Address - Phone:602-793-5063
Mailing Address - Fax:866-620-2841
Practice Address - Street 1:7531 E MCKNIGHT AVE UNIT A
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-4570
Practice Address - Country:US
Practice Address - Phone:602-793-5063
Practice Address - Fax:866-620-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLM143176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty