Individual
MS. LETA MARIE VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.M.
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
209005087
IL
367A00000X
Advanced Practice Midwife
277-000461
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209005087
STATE LICENSE
IL
Enumeration date
03/24/2006
Last updated
06/06/2022
Update your record
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