Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1114479417 |
---|---|
Provider Name | Paige Yolanda St. Cyr |
First Address | Dover, NH 03820-3107 |
Second Address | Dover, NH 03820-3107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2016 |
Last Update Date | 03/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16100011 | NARM (01) |