Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | F001564 | NY |
NPI | 1134400443 |
---|---|
Provider Name | Jennifer L Middaugh |
First Address | Wellsville, NY 14895-1149 |
Second Address | Wellsville, NY 14895-1149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2011 |
Last Update Date | 21/11/2013 |