Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW134 | FL |
NPI | 1033399951 |
---|---|
Provider Name | Ms. Jill Mcelligott Welch |
First Address | Tallahassee, FL 32315 |
Second Address | Quincy, FL 32351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2007 |
Last Update Date | 08/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
340451000 | (05) | FL |