Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | RN106344 | AZ |
NPI | 1104933670 |
---|---|
Provider Name | Marla Anne Vogt-Roberts |
First Address | Phoenix, AZ 85012-3322 |
Second Address | Phoenix, AZ 85013-4224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 05/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4704123693 | NURSE MIDWIFE SPECIALTY (01) | MI |
4704123693 | RN (01) | MI |
479130 | (05) | AZ |
7049 | CNM (01) | AZ |
MV3528710 | DEA (01) | |
RN106344 | RN (01) | AZ |