Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 00000192 | CO |
NPI | 1154950111 |
---|---|
Provider Name | Tatia L Donoho |
First Address | Briggsdale, CO 80611-0036 |
Second Address | Briggsdale, CO 80611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2020 |
Last Update Date | 02/04/2020 |