Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN.CNP.13271 | OH |
NPI | 1003172917 |
---|---|
Provider Name | Amy Elizabeth Pietragallo |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43203-1779 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2012 |
Last Update Date | 11/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0151700 | (05) | OH |