Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW354 | FL |
NPI | 1114546066 |
---|---|
Provider Name | Courtney Hilliard |
First Address | St Petersburg, FL 33712-4405 |
Second Address | Lutz, FL 33549-5632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2020 |
Last Update Date | 13/05/2020 |