Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | DEM-LD-10172788 | OR |
Y | 176B00000X | Midwife | MWR.0000179 | CO |
NPI | 1134593007 |
---|---|
Provider Name | Emily J White |
First Address | Peyton, CO 80831-4462 |
Second Address | Peyton, CO 80831-4462 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2015 |
Last Update Date | 06/12/2017 |