Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | LMW030 | SC |
NPI | 1003920331 |
---|---|
Provider Name | Mrs. Amy Bixby-Redman |
First Address | Greenville, SC 29611-2462 |
Second Address | Greenville, SC 29609-4947 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 17/03/2020 |