Individual
MS. TABITHA MIRANDA FAUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM
Contact information
Practice address
459 COUNTY ROAD 917, THEODOSIA, MO 65761-6155
Mailing address
459 COUNTY ROAD 917, THEODOSIA, MO 65761-6155
(417) 255-6883
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
CPM24080529
MO
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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