Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 0129000169 | VA |
NPI | 1144987082 |
---|---|
Provider Name | Hannah Russell-Davis |
First Address | Charlottesville, VA 22902-5437 |
Second Address | Charlottesville, VA 22902-5437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2021 |
Last Update Date | 28/11/2021 |