Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 1418 | CA |
NPI | 1164505780 |
---|---|
Provider Name | Paula Stephenie Cooper-Mcqueen |
First Address | San Marcos, CA 92069-2973 |
Second Address | San Marcos, CA 92069-2973 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 01/08/2013 |