Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife |
NPI | 1053839225 |
---|---|
Provider Name | Sarah Jean Gill |
First Address | Kansas City, MO 64108-2640 |
Second Address | Kansas City, MO 64108-2640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2017 |
Last Update Date | 01/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
250050608 | (05) | MO |