Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 9606975-4402 | UT |
NPI | 1043706625 |
---|---|
Provider Name | Leah Moses |
First Address | Kaysville, UT 84037-1730 |
Second Address | Salt Lake City, UT 84132-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2018 |
Last Update Date | 08/11/2021 |