Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1003327354 |
---|---|
Provider Name | Mrs. Mary Sue Harman |
First Address | Richmond, KY 40475-8590 |
Second Address | Richmond, KY 40475-8590 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2017 |
Last Update Date | 13/10/2017 |