Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1114688546 |
---|---|
Provider Name | Lindsey Stidham |
First Address | Dayton, OH 45402-2239 |
Second Address | Dayton, OH 45402-2239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2022 |
Last Update Date | 09/01/2022 |