Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | CPM0000000021 | TN |
NPI | 1164635587 |
---|---|
Provider Name | Ms. Ina May Gaskin |
First Address | Summertown, TN 38483-9626 |
Second Address | Summertown, TN 38483-9626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 08/07/2007 |