Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 0129000123 | VA |
NPI | 1144757279 |
---|---|
Provider Name | Nicole Hope |
First Address | Bristow, VA 20136-1354 |
Second Address | Bristow, VA 20136-1354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2017 |
Last Update Date | 19/05/2017 |