Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW61002789 | WA |
NPI | 1124669932 |
---|---|
Provider Name | Hannah Poe |
First Address | Waco, TX 76701-1711 |
Second Address | Waco, TX 76701-1711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2019 |
Last Update Date | 08/12/2020 |