Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | LM221 | AZ |
NPI | 1033738935 |
---|---|
Provider Name | Cheryl Marie Struble |
First Address | Goodyear, AZ 85338-5855 |
Second Address | Goodyear, AZ 85338-5855 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2020 |
Last Update Date | 10/04/2020 |