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Individual
SALLY ELIZABETH ACOSTA
Active
Individual
SALLY ELIZABETH ACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LM
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MDW.200006
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11030033
CERTIFIED PROFESSION MIDWIFE
LA
01
—
MDW.200006
LOUISIANA LICENSE FROM BOARD OF MEDICAL EXAMINERS
LA
Enumeration date
12/21/2011
Last updated
12/21/2011
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