Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | LMW-0042 | SC |
Y | 176B00000X | Midwife | MWR.0000177 | CO |
NPI | 1104155381 |
---|---|
Provider Name | Adrienne R. Leeds |
First Address | Longmont, CO 80503-7577 |
Second Address | Longmont, CO 80503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2009 |
Last Update Date | 18/07/2018 |