Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 02988NM | OH |
NPI | 1083624290 |
---|---|
Provider Name | Jenifer F. Tabin |
First Address | Bedford Heights, OH 44146-7110 |
Second Address | Cleveland, OH 44109-3315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 06/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
995259 | (05) | OH |