Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | NMW1774 | CA |
NPI | 1013108414 |
---|---|
Provider Name | Lisa Marie Cucinella |
First Address | Napa, CA 94558-2908 |
Second Address | Napa, CA 94558-2908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2007 |
Last Update Date | 09/08/2007 |