Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 4704240932 | MI |
NPI | 1104997949 |
---|---|
Provider Name | Heather Elizabeth Razmus |
First Address | Battle Creek, MI 49037-2963 |
Second Address | Battle Creek, MI 49037-2963 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 17/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4704240932 | LICENSE NUMBER (01) | MI |