Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 74 | AK |
NPI | 1073948758 |
---|---|
Provider Name | Heather Forbes |
First Address | Soldotna, AK 99669-7501 |
Second Address | Soldotna, AK 99669-7501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2013 |
Last Update Date | 12/09/2013 |