Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 427 | NM |
NPI | 1013919257 |
---|---|
Provider Name | Kathryn M. Autrey |
First Address | Las Cruces, NM 88011-4907 |
Second Address | Austin, TX 78758-2910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 11/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
380935201 | (05) | TX |
380935202 | (05) | TX |
S67306 | (02) | NM |
T8776 | (05) | NM |