Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1013134618 |
---|---|
Provider Name | Kelley M. Faulkner |
First Address | Milford, MA 01757-2445 |
Second Address | Milford, MA 01757-2445 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 14/02/2008 |