Provider Demographics
NPI:1912380254
Name:JAIMES MIDWIFERY SERVICES
Entity Type:Organization
Organization Name:JAIMES MIDWIFERY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CNM
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORREST JAIMES
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:480-228-0732
Mailing Address - Street 1:1427 W IMPALA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-5810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1427 W IMPALA AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5810
Practice Address - Country:US
Practice Address - Phone:480-228-0732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-06
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7426176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty