Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 71 | AK |
NPI | 1023375383 |
---|---|
Provider Name | Ms. Onica Sprokkreeff |
First Address | Palmer, AK 99645-5929 |
Second Address | Palmer, AK 99645-5929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2012 |
Last Update Date | 11/04/2012 |