Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 54049 | WI |
NPI | 1053682062 |
---|---|
Provider Name | Emma Marie Swift |
First Address | Madison, WI 53705-3303 |
Second Address | Madison, WI 53705-3303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2012 |
Last Update Date | 23/01/2012 |