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Individual

ALICIA ANNE HUNTLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
2400 ROCKTON AVE, ROCKFORD, IL 61103
(815) 971-2000
Mailing address
5970 CHURCH VIEW DR, ROCKFORD, IL 61107
(815) 971-2000

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
0480242301
NH
176B00000X
Midwife
Primary
209.006236
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3034137
IL
Enumeration date
08/31/2006
Last updated
03/16/2010
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