Provider Demographics
NPI:1114333598
Name:MAURER, ROXANNA (CPM, LDEM)
Entity type:Individual
Prefix:
First Name:ROXANNA
Middle Name:
Last Name:MAURER
Suffix:
Gender:F
Credentials:CPM, LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 S 500 W
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-2713
Mailing Address - Country:US
Mailing Address - Phone:801-787-1400
Mailing Address - Fax:801-405-0345
Practice Address - Street 1:575 S 500 W
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-2713
Practice Address - Country:US
Practice Address - Phone:801-787-1400
Practice Address - Fax:801-405-0345
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10829412-3400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife