Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | NP01488 | OH |
NPI | 1013902170 |
---|---|
Provider Name | Amy Ellen Kauffman |
First Address | Toledo, OH 43606-1326 |
Second Address | Toledo, OH 43606-1326 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2005 |
Last Update Date | 04/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2320849 | (05) | OH |
Q30245 | (02) |