Organization
WILLOW MIDWIFE CENTER FOR BIRTH AND WELLNESS AZ, LLC
Active
Other names
Willow AZ Midwives
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE M ORTEGA CNM (OWNER)
(480) 565-5990
Entity
Organization
Contact information
Practice address
2045 S VINEYARD STE 136, MESA, AZ 85210-6891
(480) 565-5990
Mailing address
2045 S VINEYARD STE 136, MESA, AZ 85210-6891
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346515
—
AZ
Enumeration date
05/28/2020
Last updated
05/28/2020
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