Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1093058448 |
---|---|
Provider Name | Michelle Beth Hernandez |
First Address | Norman, OK 73069-6459 |
Second Address | Norman, OK 73069-6459 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2013 |
Last Update Date | 04/04/2013 |