Individual
MISS EMMA LOREE PROVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1950 W FRYE RD, CHANDLER, AZ 85224-6255
(480) 895-9555
Mailing address
1950 W FRYE RD, CHANDLER, AZ 85224-6255
(480) 895-9555
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
CNM301120
AZ
Other
Enumeration date
12/13/2023
Last updated
11/05/2024
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