Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | ||
Y | 176B00000X | Midwife |
NPI | 1265776637 |
---|---|
Provider Name | Laura Donnelly |
First Address | Searsport, ME 04974-3712 |
Second Address | Searsport, ME 04974-3712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2012 |
Last Update Date | 25/11/2012 |