Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1033465117 |
---|---|
Provider Name | Holly C Fix |
First Address | St Louis Park, MN 55426 |
Second Address | Minneapolis, MN 55412-1209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2012 |
Last Update Date | 17/03/2018 |