Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 10110005 | TN |
NPI | 1013203322 |
---|---|
Provider Name | Miss Lila Merrily Fischer |
First Address | West Tisbury, MA 02575-0106 |
Second Address | West Tisbury, MA 02575-0106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2011 |
Last Update Date | 24/06/2011 |