Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 199200 | MA |
NPI | 1033260252 |
---|---|
Provider Name | Mrs. Agnes Geralyn Densmore |
First Address | Hanover, MA 02339-1657 |
Second Address | Hanover, MA 02339-1657 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2007 |
Last Update Date | 27/03/2013 |