Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 09000376A | IN |
NPI | 1093484214 |
---|---|
Provider Name | Linda J Ebright |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Bloomington, IN 47403-4214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2021 |
Last Update Date | 13/12/2021 |