Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 04090013 |
NPI | 1033430558 |
---|---|
Provider Name | Ms. Michelle Ann Stewart |
First Address | Williamsburg, PA 16693-8412 |
Second Address | Williamsburg, PA 16693-8412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2010 |
Last Update Date | 18/06/2010 |