Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | CPM0000000026 | TN |
NPI | 1114297538 |
---|---|
Provider Name | Mrs. Kathleen F Davies |
First Address | Marshall, NC 28753-5879 |
Second Address | Marshall, NC 28753-5879 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2012 |
Last Update Date | 02/01/2012 |