Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN.CNP.024109 | OH |
NPI | 1033682190 |
---|---|
Provider Name | Amanda Laird |
First Address | Lima, OH 45801-4602 |
Second Address | Lima, OH 45801-4602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2019 |
Last Update Date | 30/01/2019 |