Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 263 | CA |
NPI | 1003187261 |
---|---|
Provider Name | Ms. Heidi Marshall |
First Address | Point Arena, CA 95468-0791 |
Second Address | Gualala, CA 95445-7550 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2012 |
Last Update Date | 19/01/2012 |