Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 1088 | MN |
NPI | 1134891096 |
---|---|
Provider Name | Belinda Clary |
First Address | Saint Paul, MN 55105-3203 |
Second Address | Milaca, MN 56353-3208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2021 |
Last Update Date | 04/10/2021 |