Provider Demographics
NPI:1013058668
Name:WOMANCARE MIDWIFERY ASSOCIATES
Entity Type:Organization
Organization Name:WOMANCARE MIDWIFERY ASSOCIATES
Other - Org Name:WOMANCARE MIDWIFERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BAUL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LM, CPM
Authorized Official - Phone:928-779-6064
Mailing Address - Street 1:20 E CHERRY AVE
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-4607
Mailing Address - Country:US
Mailing Address - Phone:928-779-6064
Mailing Address - Fax:928-773-9694
Practice Address - Street 1:20 E CHERRY AVE
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-4607
Practice Address - Country:US
Practice Address - Phone:928-779-6064
Practice Address - Fax:928-773-9694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ069176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty