Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APRN.CNP.0029819 | OH |
NPI | 1124558051 |
---|---|
Provider Name | Breanna Nicole Layne |
First Address | Toledo, OH 43608-2603 |
Second Address | Toledo, OH 43608-2603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2017 |
Last Update Date | 13/01/2022 |