Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | AZ |
NPI | 1023500642 |
---|---|
Provider Name | Christy Clayton |
First Address | Mesa, AZ 85215-1639 |
Second Address | Mesa, AZ 85215-1639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2018 |
Last Update Date | 14/12/2020 |