Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | AP6188 | AZ |
N | 176B00000X | Midwife | RN031500 | AZ |
NPI | 1033226519 |
---|---|
Provider Name | Donna Tash |
First Address | Phoenix, AZ 85012-2716 |
Second Address | Phoenix, AZ 85013-4224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 26/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1927 | CNM (01) | AZ |
234282 | (05) | AZ |
MT0012675 | DEA (01) | AZ |
RN031500 | RN (01) | AZ |