Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 0129-000157 | VA |
NPI | 1003419094 |
---|---|
Provider Name | Naomi Eve Waldron |
First Address | Massanutten, VA 22840-2127 |
Second Address | Massanutten, VA 22840-2127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2020 |
Last Update Date | 20/11/2020 |