Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 1070000004 | VT |
NPI | 1124167119 |
---|---|
Provider Name | Peggy Cohen |
First Address | Burlington, VT 05401-8320 |
Second Address | Burlington, VT 05401-8320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1008583 | (05) | VT |
1008774 | (05) | VT |