Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | MW010457 | PA |
NPI | 1013438472 |
---|---|
Provider Name | Vera Mielke |
First Address | Enola, PA 17025-1233 |
Second Address | Enola, PA 17025-1233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2017 |
Last Update Date | 07/01/2022 |