Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | IN |
NPI | 1083236046 |
---|---|
Provider Name | Mrs. Brittany Chana'is Kendrick |
First Address | Muncie, IN 47303-4988 |
Second Address | Lafayette, IN 47905-8764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2020 |
Last Update Date | 14/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300041416 | (05) | IN |