Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 0129000029 | VA |
N | 176B00000X | Midwife | 08049R | NM |
N | 176B00000X | Midwife | 99047 | TX |
NPI | 1104079011 |
---|---|
Provider Name | Consuelo M. F. York |
First Address | Emporia, VA 23847-2009 |
Second Address | Emporia, VA 23847-2009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2008 |
Last Update Date | 23/10/2008 |