Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | RN2280546 | MA |
NPI | 1023623741 |
---|---|
Provider Name | Emily Mansur Fox |
First Address | Rockport, MA 01966-1348 |
Second Address | Ithaca, NY 14850-1869 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2020 |
Last Update Date | 10/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RN2280546 | N/A (01) | MA |