Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 1056574 | TX |
NPI | 1114689890 |
---|---|
Provider Name | Miss Nermine R Rofael |
First Address | Longview, TX 75605-5627 |
Second Address | Longview, TX 75601-5602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2021 |
Last Update Date | 14/10/2021 |