Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN.CNP.0029955 | OH |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN.393892 | OH |
NPI | 1023681806 |
---|---|
Provider Name | Ashley Dutkowski |
First Address | Swanton, OH 43558-9339 |
Second Address | Toledo, OH 43606-3895 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2021 |
Last Update Date | 18/10/2021 |