Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | CMW00130 | RI |
NPI | 1023340437 |
---|---|
Provider Name | Kristin Wiley |
First Address | Cheshire, CT 06410-3153 |
Second Address | Cheshire, CT 06410-3153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2010 |
Last Update Date | 27/05/2016 |