Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1003082181 |
---|---|
Provider Name | Bridgett Ann Ciupka |
First Address | Taylor, MI 48180-3926 |
Second Address | Taylor, MI 48180-3926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2008 |
Last Update Date | 07/05/2008 |