Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 0129000072 | VA |
Y | 176B00000X | Midwife | 06030015 | MD |
NPI | 1124281340 |
---|---|
Provider Name | Mrs. Valerie Rose Monterrey |
First Address | Erie, PA 16509-1552 |
Second Address | Erie, PA 16509-1552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 17/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0129000072 | COMMONWEALTH OF VIRGINIA (01) | VA |