Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 90000003A | IN |
NPI | 1164699559 |
---|---|
Provider Name | Brandi Ann Graham-Wood |
First Address | Fishers, IN 46038-2894 |
Second Address | Fishers, IN 46038-2894 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2008 |
Last Update Date | 18/05/2021 |