Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APRN.CNP.024964 | OH |
NPI | 1013577741 |
---|---|
Provider Name | Amanda Nicole Newburger |
First Address | Columbus, OH 43204-4119 |
Second Address | Columbus, OH 43205-2639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2019 |
Last Update Date | 25/06/2019 |