Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 99400 | TX |
NPI | 1013436112 |
---|---|
Provider Name | Anna Rebecca Hines |
First Address | Dallas, TX 75246-1014 |
Second Address | Dallas, TX 75246-1014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2017 |
Last Update Date | 24/06/2020 |