Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1144527094 |
---|---|
Provider Name | Rachelle B Canady |
First Address | Ashland, OR 97520-0301 |
Second Address | Ashland, OR 97520-2606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2011 |
Last Update Date | 11/02/2011 |