Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | F001691-1 | NY |
NPI | 1154776870 |
---|---|
Provider Name | Franchesca Moreau Desriviere |
First Address | Honolulu, HI 96859 |
Second Address | Honolulu, HI 96859 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2016 |
Last Update Date | 30/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD000 | (02) |