Provider Demographics
NPI:1962648691
Name:COUCH, PATRICIA MARGARITE (CPM, LM)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARGARITE
Last Name:COUCH
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 1:8000 WERKNER RD
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118
Mailing Address - Country:US
Mailing Address - Phone:734-433-8355
Mailing Address - Fax:734-480-8827
Practice Address - Street 1:110 N. MAIN STREET #3
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118
Practice Address - Country:US
Practice Address - Phone:734-433-8355
Practice Address - Fax:734-480-8827
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDEMLD10128833176B00000X
MI7601000093176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR10128833OtherOREGON HEALTH LICENSING AGENCY
ORDEMLD10128833OtherOREGON HEALTH LICENSING AGENCY
08110003OtherNORTH AMERICAN REGISTRY OF MIDWIVES