Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | R061758-7 | MN |
NPI | 1154380657 |
---|---|
Provider Name | Linda A Gellerman |
First Address | Apple Valley, MN 55124-9721 |
Second Address | Woodbury, MN 55125-2298 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R82834 | (02) | MN |