Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | SP015100 | PA |
NPI | 1033589940 |
---|---|
Provider Name | Brittany Kohl |
First Address | Greensburg, PA 15601-2861 |
Second Address | Greensburg, PA 15601-2861 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2015 |
Last Update Date | 05/10/2015 |