Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 0024177305 | VA |
NPI | 1073070553 |
---|---|
Provider Name | Andrea Stoneburner |
First Address | Mechanicsville, VA 23116-5139 |
Second Address | Midlothian, VA 23114-3222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2019 |
Last Update Date | 21/02/2019 |