Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | AZ |
NPI | 1043476591 |
---|---|
Provider Name | Ms. Lorena Patricia Cavazos |
First Address | Phoenix, AZ 85004-1130 |
Second Address | Phoenix, AZ 85042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 01/09/2009 |