Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW60130114 | WA |
NPI | 1013142330 |
---|---|
Provider Name | Mrs. Loritha Ann Fitzpatrick |
First Address | Sequim, WA 98382-6812 |
Second Address | Sequim, WA 98382-6812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2009 |
Last Update Date | 17/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AK3516 | OR DEPT. OF HEALTH NEWBORN SCREENING (01) | AK |
NM0039 | (05) | AK |