Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | NMW 923 | CA |
NPI | 1124120662 |
---|---|
Provider Name | Marilyn Marie Platt |
First Address | Apple Valley, CA 92307-4705 |
Second Address | Apple Valley, CA 92307-2215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NMW923 | MID-WIFERY LICENSE (01) | CA |