Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | LM134 | AZ |
NPI | 1013207042 |
---|---|
Provider Name | Karen Alexander |
First Address | Prescott Valley, AZ 86314-2477 |
Second Address | Prescott Valley, AZ 86314-2477 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2011 |
Last Update Date | 11/04/2011 |