Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 012004 | AR |
NPI | 1093111072 |
---|---|
Provider Name | Heather Chowdhury |
First Address | Fayetteville, AR 72701-8868 |
Second Address | Fayetteville, AR 72701-8868 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2014 |
Last Update Date | 18/11/2014 |