Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 99091 | TX |
NPI | 1033449822 |
---|---|
Provider Name | Ame North Farmer |
First Address | Fort Worth, TX 76133-1409 |
Second Address | Fort Worth, TX 76133-1409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2009 |
Last Update Date | 30/12/2009 |