Provider Demographics
NPI:1780608828
Name:KNOWLES, MACHEL (CNM)
Entity type:Individual
Prefix:
First Name:MACHEL
Middle Name:
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 E 6000 S
Mailing Address - Street 2:
Mailing Address - City:SO OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-7144
Mailing Address - Country:US
Mailing Address - Phone:801-337-5800
Mailing Address - Fax:801-337-5809
Practice Address - Street 1:1525 E 6000 S
Practice Address - Street 2:
Practice Address - City:SO OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-7144
Practice Address - Country:US
Practice Address - Phone:801-337-5800
Practice Address - Fax:801-337-5809
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1935364402176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD2851Medicaid
UT160009437OtherMEDICARE RAILROAD
UTD2851Medicaid
UT160009437OtherMEDICARE RAILROAD