Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 43507 | KY |
Y | 2084N0402X | Child Neurologist | 43507 | KY |
NPI | 1013057017 |
---|---|
Provider Name | Anna O Ehret |
First Address | Chicago, IL 60677-6879 |
Second Address | Owensboro, KY 42303-0877 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 26/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43507 | LICENSE (01) | KY |