Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | APRN.CNP.025123 | OH |
NPI | 1013552736 |
---|---|
Provider Name | Alexa Layne Hirschfeld |
First Address | Sylvania, OH 43560-3303 |
Second Address | Perrysburg, OH 43551-2983 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2019 |
Last Update Date | 18/11/2019 |