Individual
TANZANIA VICINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
AC000422
MD
367A00000X
Advanced Practice Midwife
Primary
R190581
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC000422
RN LICENSE
MD
Enumeration date
02/16/2007
Last updated
02/25/2019
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