Provider Demographics
NPI:1801160395
Name:CEFALO, AMY VAUGHN (LM, CPM)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:VAUGHN
Last Name:CEFALO
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 250937
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72225-0937
Mailing Address - Country:US
Mailing Address - Phone:501-590-6285
Mailing Address - Fax:
Practice Address - Street 1:19801 JONES RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72206-9088
Practice Address - Country:US
Practice Address - Phone:501-590-6285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife