Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 257703 | MA |
NPI | 1134194442 |
---|---|
Provider Name | Julie Mann |
First Address | Cambridge, MA 02138-5502 |
Second Address | Cambridge, MA 02138-5502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 09/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q42687 | (02) | MA |