Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 99122 | TX |
NPI | 1164714895 |
---|---|
Provider Name | Mrs. Monika Stone |
First Address | Austin, TX 78749-4924 |
Second Address | Austin, TX 78749-4924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2011 |
Last Update Date | 16/04/2018 |