Active NPI
Maryn Leister, L.M.
- Midwife
- Cornville, AZ
National Provider Identifier
1346479482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- LM0159
- Practice address
- 1275 S Western Dr
Cornville, AZ 86325-5201 - Phone
- (928) 649-1340
- NPI assigned
- Jul 10, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | LM0159 | AZ | Primary |
Addresses
Primary practice location
1275 S Western Dr
Cornville, AZ 86325-5201
Mailing address
1275 S Western Dr
Cornville, AZ 86325-5201
Phone (928) 649-1340
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LM0159 | AZ | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247184000000",
"number": "1346479482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1275 S WESTERN DR",
"city": "CORNVILLE",
"state": "AZ",
"postal_code": "863255201",
"telephone_number": "928-649-1340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 S WESTERN DR",
"city": "CORNVILLE",
"state": "AZ",
"postal_code": "863255201",
"telephone_number": "928-649-1340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEISTER",
"first_name": "MARYN",
"credential": "L.M.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-10",
"last_updated": "2009-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "AZ",
"license": "LM0159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cornville, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.