Provider Demographics
NPI:1124619986
Name:WOLOSUK HARDIN, MARTHA MARIE (CNM)
Entity type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:MARIE
Last Name:WOLOSUK HARDIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20316 ELK HOUND LN
Mailing Address - Street 2:
Mailing Address - City:YALE
Mailing Address - State:VA
Mailing Address - Zip Code:23897-5428
Mailing Address - Country:US
Mailing Address - Phone:434-637-1327
Mailing Address - Fax:
Practice Address - Street 1:20316 ELK HOUND LN
Practice Address - Street 2:
Practice Address - City:YALE
Practice Address - State:VA
Practice Address - Zip Code:23897-5428
Practice Address - Country:US
Practice Address - Phone:434-637-1327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife