Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | CPM21120020 | MO |
NPI | 1033870928 |
---|---|
Provider Name | Mrs. Bethany Sims |
First Address | Springfield, MO 65804-2700 |
Second Address | Springfield, MO 65804-2700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2022 |
Last Update Date | 04/01/2022 |