Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 71008871A. | IN |
NPI | 1073073599 |
---|---|
Provider Name | Ashley Nicole Kohler |
First Address | Valparaiso, IN 46383-8948 |
Second Address | Valparaiso, IN 46383-8948 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2019 |
Last Update Date | 08/11/2021 |