Provider Demographics
NPI:1386350148
Name:PRICE, EVA M (CPM, LDEM)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:M
Last Name:PRICE
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 1:10567 N ABERDEEN LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-8838
Mailing Address - Country:US
Mailing Address - Phone:801-376-4051
Mailing Address - Fax:
Practice Address - Street 1:10567 N ABERDEEN LN
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:UT
Practice Address - Zip Code:84003-8838
Practice Address - Country:US
Practice Address - Phone:180-137-6405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13258859-3400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife