Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 0129-000154 | VA |
NPI | 1124657879 |
---|---|
Provider Name | Amy Michaelson-Ratcliffe |
First Address | South Mills, NC 27976-9555 |
Second Address | South Mills, NC 27976-9555 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2020 |
Last Update Date | 05/04/2020 |