Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 311071 | LA |
NPI | 1033680871 |
---|---|
Provider Name | Sarah Beth Anderson |
First Address | Duson, LA 70529-3601 |
Second Address | Duson, LA 70529-3601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2018 |
Last Update Date | 05/12/2018 |