Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 105-49 | WI |
NPI | 1164891446 |
---|---|
Provider Name | Erin O'day |
First Address | Genesee Depot, WI 53127-0365 |
Second Address | Genesee Depot, WI 53127-0365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2015 |
Last Update Date | 17/09/2015 |