Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | LM284 | CA |
NPI | 1093132375 |
---|---|
Provider Name | Alexandra Brooke Michel |
First Address | Oakhurst, CA 93644-0233 |
Second Address | Oakhurst, CA 93644-9537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2014 |
Last Update Date | 25/03/2014 |