Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 14246 | TN |
NPI | 1114196243 |
---|---|
Provider Name | Melissa Leigh Allred |
First Address | Wright-Patterson Afb, OH 45433-5529 |
Second Address | Wright-Patterson Afb, OH 45433-5529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2008 |
Last Update Date | 04/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1114196243 | (05) | PA |
1517584 | (05) | TN |