Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1124619986 |
---|---|
Provider Name | Mrs. Martha Marie Wolosuk Hardin |
First Address | Yale, VA 23897-5428 |
Second Address | Yale, VA 23897-5428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2021 |
Last Update Date | 03/02/2021 |